Fallacious fracture of clavicle after cardiac surgery

Corresponding author: Abhishek Bansal, MD Department of Anaesthesiology and Critical Care Medanta-The Medicity Sector 38 Gurgaon, Haryana, India e.mail: [email protected] Artefacts are quite common in chest radiographs and may lead to unnecessary imaging and interventions, if not recognized timely. A 70 year old male with triple vessel coronary artery disease underwent coronary artery bypass grafting (CABG) at our institute. Preoperative history was unremarkable. Procedure was uneventful with three grafts. Post procedure, the patient was shifted to intensive care unit. on duty resident noticed fracture left clavicle on postoperative chest radiograph which was not present earlier (Figure 1). Palpation of the site did not reveal any gap or crepitus. on repeating the chest radiograph, clavicle was found to be intact with no discontinuity of margins (Figure 2). on comparison of the two radiographs, the earlier was found to be a rotated film with improper centring and lateral tilt, which fallaciously gave the impression of fractured clavicle. Musculoskeletal complications of upper limb are not uncommon complications of CABG. Stiller et al reported that approximately 30 per cent of patients developed musculoskeletal complications that interfered with their level of comfort and function 8-10 weeks following cardiac surgery (1). Musculoskeletal and neurological dysfallacious fracture of clavicle after cardiac surgery