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Case Reports
. 2025 Sep 12;17(9):e92145.
doi: 10.7759/cureus.92145. eCollection 2025 Sep.

Surgical Management of an Isolated Posterior Manubrium Fracture in a Division One Collegiate Ice Hockey Athlete: A Case Report

Andin E Fosam  1 , Jacob Friedman  2 , Connor Mitrovich  2 , Justin Blasberg  3 , Christina R Allen  1
Affiliations
Case Reports

Surgical Management of an Isolated Posterior Manubrium Fracture in a Division One Collegiate Ice Hockey Athlete: A Case Report

Andin E Fosam et al. Cureus. .

Abstract

A 21-year-old, Division One men's ice hockey athlete, sustained a traumatic, left shoulder injury that resulted in a displaced posterior left-sided manubrium fracture. Due to persistent pain that limited return to sport and fracture non-union, he underwent fracture fragment resection via an open transpectoralis major approach. The patient's pain fully resolved, and he returned to sport-specific activities two months after surgery with the anticipation of full participation in contact activity upon return to campus. Isolated fractures to the manubrium, while uncommon, are generally associated with severe concomitant injuries. Contact sport athletes are at risk for manubrium fractures despite the few documented reports. Surgical management should be considered for cases of manubrium fractures in patients with persistent pain.

Keywords: high-contact sports; ice hockey injury; isolated manubrium fracture; sports-induced injury; surgical management of fractures.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Representative mechanism of injury and computed tomography (CT) scan of the displaced fracture to the left posterior aspect of the manubrium.
(A) Representative diagram of the anterior aspect of the manubrium indicating a fracture located on the upper left, posterior aspect. The arrow indicates the medially-directed force by the clavicle on the manubrium at the time of injury. (B) CT scan of the chest showing a minimally-displaced manubrium fracture in axial view (white arrow) post-injury. (C) 3D CT representation of a side view of the manubrium showing the anterior aspect of the left side of the manubrium (orange arrow) and demonstrating the posterior location of the fracture (yellow arrow) in proximity to the articular site of the left clavicle (blue arrow). Abbreviations: A = anterior; SC = sternoclavicular; L = left
Figure 2
Figure 2. CT scan of the fractured manubrium three months post-injury.
Axial view of the chest highlighting non-union of the left posterior aspect of the manubrium with minimal bony healing and sclerosis (white arrow).
See this image and copyright information in PMC

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