The clavicle is the only long bone in the body that lies horizontally. Refracture secondary to additional trauma either medial or lateral to the original hardware is thus possible, and in fact is reported at rate of between 1% and 2%. Handbook of fractures pdf 3rd edition, written by leading orthopedic surgeons, this superbly illustrated pocket guide helps you expertly diagnose, classify, and, most importantly, manage every type of fracture and ligamentous injury commonly seen in clinical practice. Radiographs and a computed tomography scan showed an undisplaced fracture through the medial third of the clavicle extending inferiorly to the rhomboid fossa in the inferior aspect of the clavicle. Sagging shoulder down and forward inability to lift the arm because of pain. Nonoperative treatment of midshaft clavicle fractures in adults. This fact sheet outlines the care and management of a child with a fractured collarbone.
Clavicle fracture introduction clavicle fractures are a common orthopedic injury, particularly among infants and young children. Typically a midshaft clavicle fracture occurs from a fall directly on the point of the shoulder. Physiotherapy department helping your clavicle to recover after a fracture. Clavicle fractureshaft childrens hospital at montefiore. Clavicle fractures are often caused by a direct blow to the shoulder. Clavicle fracture an overview sciencedirect topics. Together with the shoulder blade, it makes up the shoulder girdle. Clavicle fracture broken collarbone a broken collarbone is also known as a clavicle fracture.
Immobilized at all times day and night off for hygiene and gentle exercise only. Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. A clavicle fracture is typically associated with extreme pain, and arm movement is difficult. Males are more prone to fracture than females 68% versus 32%. Trauma is the most common cause of a clavicle fracture. Patients under years and those with ligamentous injuries or dislocations without fracture were exluded as were those with double disrup. The clavicle is the bone that connects the scapula to the sternum. It articulates with the acromion process of the scapula laterally, at the. Introduction in children the clavicle fractures easily, but it almost invariably unites rapidly and without complications. Pdf treatment of clavicle fractures giovanni merolla.
Cole, md, mba range of motion immobilizer exercises phase i 06 weeks 03 weeks. The clavicle, or collarbone, is a long bone that serves as a strut between the shoulder blade and the sternum breastbone. An athletic trainer or physician on the field can usually make the diagnosis right away. Weakness, numbness, or tingling in your shoulder and arm. Although plating of the clavicle spans the original fracture site, it rarely involves fixation along its entire length. A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. The clavicle bone, also known as the collarbone, is one of the most exposed bones in the body and serves to strengthen the connection between the arm, shoulder, and rib cage while also protecting the important blood vessels underneath. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. A clavicle fracture, or the collarbone, is unfortunately a common injury in contact and collision sports, such as football. Sometimes, if the break causes the two ends of the bone to be far apart from each other or a lot of overlap of the bones, surgery may be recommended. Large multicentre studies of clavicle fractures have so far been missing. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon.
Clavicle fractures are very common injuries in adults 25% and children 1015 % 1 and represent the 4466% of all shoulder fractures 2. Jan 01, 2008 the usual mechanism of a clavicle fracture is a fall directly on the shoulder with the arm at the side. Fractures of the clavicle are common injuries accounting for between 2. Clavicle fractures are among some of the most common bone fractures seen in the medical community. The clavicle will show deformity at the fracture site. However, recent wellconducted studies demonstrate that plate fixation of displaced midshaft clavicle fractures may result in improved functional outcome and a lower rate of malunion and nonunion, compared. Pain at the clavicle or top of the shoulder, especially with shoulder movement. However, in some cases, open reduction and internal fixation are required. The most common type, accounting for 8085% of clavicle fractures in both children and adults as this is the weakest part of the bone presentation. One child with a fracture of the clavicle also had a fracture of the scapula, and the rest of study newborns were free from other fractures or bone abnormalities. Complications can include a collection of air in the pleural space surrounding the lung pneumothorax, injury to the nerves or blood vessels in. A clavicle fracture is a break in your clavicle collarbone. An overview article pdf available in the open orthopaedics journal 71.
In children, the injury may occur at the growth plate, closer to the end of the bone. Despite the name, the collarbone isnt really in your neck. Clavicle fractures also called simply broken collarbones are a familiar woe to many athletes. The treatment ranges from nonoperative treatment in a sling to open treatment with metallic implants. Typically the injury occurs when the athlete lands on his or her shoulder.
A scapular fracture is a break in the shoulder blade, which is the bone that joins the humerus and the clavicle. It is a touchable bone, and in people who have less fat in this region. Re fracture secondary to additional trauma either medial or lateral to the original hardware is thus possible, and in fact is reported at rate of between 1% and 2%. This is the report of one such fracture in a 10 year old female gymnast, who presented with a six week history of medial clavicular pain. Pain and swelling can be eased by applying ice for approx 10 minutes 34 times. Most clavicle fractures occur in the midshaft and can be treated nonoperatively. Complications can include a collection of air in the pleural space surrounding the lung pneumothorax, injury to the nerves or blood vessels in the area, and an unpleasant appearance. This is a very common fracture that occurs in people of all ages. Clavicle fractures are a common orthopedic injury, particularly among infants and young children. Clavicle fractures matthew pecci, md, and jeffrey b. There are two clavicles, one on the left and one on the right. Rarely, clavicle fractures can occur from a direct blow or from a fall on an outstretched. Jan 18, 2012 although plating of the clavicle spans the original fracture site, it rarely involves fixation along its entire length. Nonoperative management of midshaft clavicular fractures.
This type of fracture is fairly commonaccounting for about 5 percent of all adult fractures. This essentially connects your arm to the rest of the body. This fact sheet provides information on what to do once your child has been treated in hospital for a clavicle fracture. Swelling and pain your clavicle and shoulder may still be swollen and bruised. The least common type of shoulder fracture, this injury is usually caused by sudden trauma from a long fall or a highimpact collision. May 11, 2020 the clavicle is an elongated, sshaped bone that rests horizontally at the sternum across the upper part of the ribcage, and the acromial end of the scapula this bone is an important part of the skeletal system since it plays an essential role in everyday functional movement, serving as the connection between the axial skeleton and the pectoral girdle. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks.
Provide parent with fracture of the clavicle collarbone fact sheet. Pain from the fracture and restriction of movement are usual for 23 weeks and will require regular analgesia. Clavicle fracture broken collarbone aurora health care. Data were retrieved from the sfr on all clavicle fractures sustained by patients. In adults this can be a much more troublesome injury epidemiology in adults clavicle fractures 2. Physiotherapy department helping your clavicle to recover. A traumatic break will be so painful that its hard to move your arm.
Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks. The inner end of the clavicle joins the sternum breastbone. Definitive reconstruction using free vascularized bone flapa. Fractured clavicle the student health provider has diagnosed a fracture break of your clavicle collarbone. The unit had an estimated mean catchment population over years of age for this period of 556 469. Fracture of the clavicle is very common in people of any age. In young adults and children, mechanisms include sports injuries, motor vehicle accidents, and falls, while in the elderly. Clavicle fracture broken collarbone a broken collarbone is also. Stress fracture of the clavicle in a young female gymnast. Jun 28, 2016 about 30% of the clavicle fixation plates are removed after the fracture has completely healed. In fact, they account for about 5% of all fractures seen at the hospital.
Fractures or breaks of the clavicle are common injuries during childhood and with falls onto the shoulder. Common symptoms of a fractured shoulder blade include. Sean griffin weeks full time in sling avoid ir behind the back, lifting more than 12 lbs, and horizontal adduction. The clavicle, also referred to as the collarbone, is a long bone located at the top of the chest. The clavicle also forms the bony connection between the upper limb and the thorax. The fact sheet details the care in the first few days, what is normal and what is. A broken collarbone clavicular fracture is a common injury that is often caused by a fall from a bicycle or injury during a contact sport like football. The figureofeight clavicle strap is continued at all times. Midshaft fractures 6982 per cent, lateral fractures 2128 per cent medial fractures 23 per cent anatomy. Feb 03, 2020 a clavicle fracture is a break in your clavicle collarbone. The clavicle, proximal humerus and the scapula together form the shoulder joint.
Kreher, md, boston university, boston, massachusetts c lavicle fractures constitute 5 patient information. Clavicle shaft fracture pediatric pediatrics orthobullets. Clavicle fractures account for 5% to 15% of childhood fractures, and are the most common type of fracture in children. Weeks 04 the patient is instructed in active and prom exercises to the shoulder. It articulate with sternum medially to form sternoclavicular joint.
The clavicle bone lies just beneath the skin, so a fracture usually causes an obvious protrusion or bump at the fracture site, along with swelling. Pain and tenderness a bump over the midpoint of the bone a lowered or sagging shoulder in children, the injury may occur at the. Clavicle fractures usually occur in the middle of the bone. Fractures of the clavicle, which account for 24 % of all fractures, have a bimodal distribution, with the most common causes from a direct blow to the shoulder or a fall on an outstretched arm. The symptoms of a fractured or broken collarbone can vary depending on the type of break and its location.
The child should reattend if pain is increasing, or sensation changes abruptly. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Do not return to contact sport until you are pain free and at least 8 weeks after your injury. Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2.
Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on. The figure of eight clavicle strap is continued at all times. Injuries of shoulder girdle clavicle fracture scapula fracture 2. Although the elbow and hand remain free for activities with the figureofeight brace, only 7% of. Clinicians working in emergency departments and general clinics should be familiar with the common presentations and complications of this injury, as well as basic management. Its superficial location, its thin midshaft, and the forces trans. In babies, these fractures can occur during the passage through the birth canal. The majority of clavicle breaks will heal without surgery.
The clavicle see diagram is a long, thin bone located in the upper, front chest. The emphasis of this article is on the management of these injuries. Is an sshape long, curved,tubular bone, lies horizontally a cross the root of neck. A fracture also known as a break can occur from a direct blow to the shoulder. The majority of clavicle fractures can heal without surgery. A shaft clavicular fracture is a complete or incomplete break fracture in the middle third of the collarbone clavicle in the shaft. Most fractures occur in the middle third, but can occur at either end. The clavicle is an elongated, sshaped bone that rests horizontally at the sternum across the upper part of the ribcage, and the acromial end of the scapula this bone is an important part of the skeletal system since it plays an essential role in everyday functional movement, serving as the connection between the axial skeleton and the pectoral girdle. About 30% of the clavicle fixation plates are removed after the fracture has completely healed.
Fractures joint replacement sports medicine clavicle fracture orif protocol dr. They usually require minimal treatment, which relies on analgesia and a collarandcuff. Introduction clavicle one of the most commonly fractured bones 2. Early reports of clavicle fractures date back to hippocrates, who noted that when a fractured clavicle is fairly broken across it is more easily treated, but when broken obliquely it is more difficult to manage. The clavicle, also referred to as the collarbone, is a long bone. Mckee md and the canadian orthopaedic trauma society. Pain should serve as the guide for the rom obtained. Symptoms clavicle fractures can be very painful and may make it hard to move your arm.
Introduction clavicle fractures occur commonly, often as a result of indirect or direct trauma to the shoulder region. Clavicle fractures are most common in children and young adults, typically occurring in per sons younger than 25 years. The clavicle, also known as the collarbone, is the bone that connects the sternum and the shoulder blade. Historically, only unstable distal clavicle fractures were treated operatively. The aim of this observational study was to describe the epidemiology, classification and treatment of clavicle fractures in the the swedish fracture register sfr that collects national prospective data from large fracture populations.
After surgery you will be taken to the recovery room room, where your family can meet you. A multicentre randomized controlled trial of nonoperative versus operative treatment of displaced clavicle shaft fractures. Other signs of a clavicle fracture or broken collarbone include. Handbook of fractures pdf latest edition free download ebook.
If the fracture is displaced the outer lateral side of the clavicle is usually pulled down due to the weight of the arm and the inner. Most clavicle fractures are undisplaced, which means that the bone remains correctly aligned, or they are only slightly displaced. Anatomy the collarbone clavicle is located between the ribcage sternum and the shoulder blade scapula, and it connects the arm to the body. Clavicle fracture broken collarbone orthoinfo aaos. Complications associated with clavicular fracture ceconnection.
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