Clavicle fracture

Revision as of 06:30, 17 June 2017 by Josgood (talk | contribs) (Evaluation)

This page is for adult patients; see Clavicle fracture (peds) for pediatric patients

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:

Evaluation

  • CXR
    • XR should include both AC joints, to allow better comparison
  • Consider dedicated clavicle or shoulder XR
  • If high suspicion and no 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