These injuries are common and usually result from a fall directly onto the tip of the shoulder. They present with pain and a large bump over the end of the clavicle where the clavicle has come out of its joint with the shoulder blade.
They have been classified by Rockwood into 7 different types depending on severity and direction of dislocation.
X-rays usually demonstrate the abnormality well and further imaging is often not required.
Treatment for many of these injuries is non surgical. The arm is rested in a sling for 2-3 weeks, and then mobilised. The pain generally settles at 12 weeks with recovery of a full range of functional movement. Patients are left with a bump over the shoulder, and the joint remains dislocated, though seems to cause very little problem. There are plenty of first class rugby players with such injuries who manage just fine.
A small number of patients experience persistant pain and decreased function. Such problems are treated operatively, with a reconstruction of the joint, often using an artificial ligament.