The patient fell off a motorcycle incurring injuries on the right side and shoulder. Difficulty breathing and hypotension in the initial phase. Native chest x-ray shows a dislocated fracture and a small loose bone fragment in the middle third of the clavicle (dislocation by half of the thickness of the bone). Fractures also in the 2nd rib (dislocated by half of the thickness of the bone) and a smaller fracture in the 3rd rib, concealed under the clavicle. Fractures also in the 5th and 6th ribs, and a suspected one in the 4th rib. Extensive contusion changes in the right lung, subcutaneous emphysema in the right side.
Picture source: Medimage / University of Turku. By courtesy of the Finnish Ministry of Education.