A delayed and recurrent pneumothorax complicating a fractured clavicle – A novel presentation

Abstract

There are very few reports in the literature about clavicular fractures being associated with a pneumothorax. With this combination of injuries, there are also minimal reports of a delayed presentation of a pneumothorax. This is the first report of a delayed pneumothorax followed by a recurrence of a pneumothorax due to the fractured ends of the clavicle. This case report describes a 49-year-old man who sustained a right-sided pneumothorax from a fractured clavicle several hours after a bus accident. His initial chest examination and radiographs showed no evidence of a pneumothorax. The pneumothorax resolved after 5 days of treatment with a thoracostomy tube. After removing the tube, the procedure was repeated later that day as he again developed a pneumothorax. Ten days later, the patient had surgical intervention of the clavicle due to the unresolved pneumothorax. The clavicle is usually managed conservatively in patients sustaining a clavicular fracture and pneumothorax, however, surgical intervention was mandatory based on failed conservative management. At 3 months follow up, the patient had normal shoulder function. Clinicians must be aware that fractured ends of the clavicle may cause repeated pulmonary damage resulting in a delayed and or a recurrent presentation of a pneumothorax. Keywords: Clavicle, Delayed pneumothorax, Recurrent pneumothorax, Fracture, Thoracostomy tube, Novel