Difference between revisions of "Clavicle fracture"

(Consult ortho for)
(Diagnosis)
Line 18: Line 18:
 
==Diagnosis==
 
==Diagnosis==
 
*[[CXR]]
 
*[[CXR]]
 +
**XR should include both AC joints, to allow better comparison
 +
* Consider dedicated clavicle or shoulder XR
 
*If high suspicion and fracture on CXR, consider CT
 
*If high suspicion and fracture on CXR, consider CT
 
**Routine imaging may miss some fractures (particularly at either end of the bone)
 
**Routine imaging may miss some fractures (particularly at either end of the bone)

Revision as of 17:01, 10 November 2015

Background

  • Middle third: 80%
  • Distal third: 15%
  • Medial third: 5%

Clinical Features

  • Occurs via direct blow to shoulder
  • Swelling, deformity, and tenderness overlying the clavicle
  • Arm is supported by the other extremity
  • Distal fracture often associated with coracoclavicular ligament rupture
  • Medial fracture often associated with intrathoracic injuries

Differential Diagnosis

Thoracic Trauma

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

Diagnosis

  • CXR
    • XR should include both AC joints, to allow better comparison
  • Consider dedicated clavicle or shoulder XR
  • If high suspicion and fracture on CXR, consider CT
    • Routine imaging may miss some fractures (particularly at either end of the bone)

Management

Consult ortho for

  • Open fracture or persistent skin tenting
  • Comminution
  • Displacement

See Also

References