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Type II Clavicle Frx (Medial to CC Ligaments)

- Discussion:
    - characterized by tearing of coracoclavicular ligaments & upward displacement of the medial fragment;
          - displacement secondary to frx medial to the CC ligaments
- Deforming Forces:
     - wt of arm pulls outer fragment downward and forward due to attachments of trapezoid ligament to scapula;
     - pectoralis major and minor muscle and the latissimus muscles draw distal segment downward & medially, causing over riding;

- Classification:
     - Type A - conoid and trapezoid attached to distal fragment
     - Type B
           - conoid torn, trapezoid attached to distal fragment
           - IIb frx has high incidence of non union due to deforming forces:

- Treatment:
    - because they are unstable & prone to nonunion, type II frx often require surgical rx, particularly if frx frag are widely separated;
    - reducing displaced clavicle & securing it to Coracoid process is preferred

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