Sports participation and radiographic findings of adolescents treated nonoperatively for displaced clavicle fractures. Fractures of the clavicle are usually treated conservatively. Clavicular fractures made up 3% of the cases in our own records. For the most part, they have been historically treated conservatively with acceptable results. The type ii distal clavicle fracture demonstrates displace. Fractures and nonunions of the clavicle springerlink. The usual or routine treatment is perhaps far short of satisfying, relieving therapy. A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. Changes in clavicle length in acute fractures within 3 weeks. The majority of clavicle fractures can heal without surgery.
Use at all times when up and about and when sleeping. Jan 31, 2011 fractures of the clavicle le kim trong md. Type ii distal clavicle fractures, which involve displacement, are associated with the highest incidence of nonunion. Clavicle fractures are common fractures that usually affect children and adolescents and typically occur from a direct fall onto the shoulder. Clavicle fracture knowledge for medical students and. This type of fracture is fairly commonaccounting for about 5 percent of all adult fractures. Broad arm sling to support limb for 2 weeks or until comfortable. She gained full range of movement and was pain free at 6 weeks post operatively.
The inner end of the clavicle joins the sternum breastbone. Fractures of the clavicle are common, accounting for 35% of all fractures in adults, most often caused by a simple fall on the outstretched hand or a direct impact on the shoulder. You will be told when to start these exercises and which ones will work best for you. A second surgery for plate renewal and bone grafting may be necessary in a large percentage of these. Pdf fractures of the clavicle are a common injury and most often occur in younger individuals. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. The most common place for an adult to break this bone is in the shaft, or middle third, of the bone. Nonoperative treatment of midshaft clavicle fractures in adults. Clavicle fractures are common, occurring in up to 5% of all fractures and 35% of shoulder girdle fractures 1. Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. Sports participation and radiographic findings of adolescents treated. Distal clavicle fracture repair using cortical button fixation with.
Alan barber neer classified fractures of the distal clavicle into two types depending upon whether the coracoclavicular ligaments were torn. The clavicle is the bone in the body most frequently fractured, accounting for 5% to 10% of all fractures. Explain why the clavicle commonly fractures fracture of the clavicle. A clavicle fracture is typically associated with extreme pain, and arm movement is difficult.
Health, general fracture fixation health aspects research fracture repair care and treatment fractures injuries. The clavicle also forms the bony connection between the upper limb and the thorax. A variety of complications can be associated with clavicle fractures, regardless of the form of treatment. 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. Complications of clavicle fractures treated with intramedullary. The clavicle, proximal humerus and the scapula together form the shoulder joint. Analyse the forces acting in the fracture during activities. Clavicle collarbone fracture sports medicine today. Clavicle fractures, especially of the mid third, are an injury commonly seen in clinical practice, therefore, there is constant earnest discussion of the optimal approach to therapy. Clavicle and sternoclavicular joint right clavicle and.
Clavicle suggestions for some daily stretches to start with at home. A clavicle fracture is a break in your clavicle collarbone. Type ii distal clavicle fractures, which involve displacement, are. Clavicle fractures are common, and it is important for primary care physicians to be familiar with basic principles of evaluation and management in order to initiate treatment as well as discuss these injuries with patients and consulting orthopedic surgeons. Management of distal clavicle fractures abstract most clavicle fractures heal without difficulty. Here are some examples of exercises for you to try. This essentially connects your arm to the rest of the body. Fractures of the clavicle are among the most frequent and least harmful of the fractures which may occur in children. Clavicle fracture knowledge for medical students and physicians. Clavicle fractures matthew pecci, md, and jeffrey b. Weakness, numbness, or tingling in your shoulder and arm.
The exercises may be suggested for a condition or for rehabilitation. The clavicle is the only bony link between the shoulder and the body itself, as well as providing protection to important underlying blood vessels and nerves. Many of you will be reading this because you were told that surgery was necessary to fix your clavicle. Kreher, md, boston university, boston, massachusetts c lavicle fractures constitute 5 patient information.
A few published case reports on bilateral clavicle fractures. 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. Measurements were performed within the first three weeks after a lateral or mid clavicular fracture. The clavicle see diagram is a long, thin bone located in the upper, front chest. 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. You may not embed one of our images on your web page without a link back to our site. Most surgeons prefer nonoperative treatment of nondisplaced midshaft clavicle fractures.
Fractures of the clavicle are a common injury and most often occur in younger individuals. A type i lateral clavicle fracture occurs distal to the cc ligaments, resulting in a minimally displaced fracture that is typically stable. The clavicle collarbone is the prominent bone on either side at the front of your shoulders and top of chest see anatomy. The number and diversity of the methods of treatment in use suggest that in most cases good results are obtained despite medical supervision. Lcp superior clavicle plate with lateral extension lcp superior clavicle plate. Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2. She gained full range of movement and was pain free at 6 weeks postoperatively. 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. Rowe, 1968 although fractures of the clavicle typically do. Influence of clavicle midshaft fracture pattern on the superior plate. Pain at the clavicle or top of the shoulder, especially with shoulder movement. The patient was free of symptoms for 9 years and played high level tennis during this period.
Apr 12, 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. If you continue browsing the site, you agree to the use of cookies on this website. Scribd is the worlds largest social reading and publishing site. Give parent fracture of the clavicle collarbone fact sheet. These injuries are almost always the result of trauma often a direct blow to the. Jan 18, 2012 clavicle fractures are very common injuries in adults 25% and children 1015% and represent the 4466% of all shoulder fractures. Fractures of the clavicle and scapula springerlink. Internal fixation may be indicated if the fragments are markedly displaced or compress the brachial plexus. The anatomically precontoured fixation system with angular stability for clavicle shaft and lateral clavicle. Most fractures occur in the middle third, but can occur at either end. The type i distal clavicle fracture did not have ligamentous injury and presented few problems long term.
Displaced clavicle fractures can be associated with skin necrosis, neurovascular injury, pneumothorax, nonunion, malunion, posttraumatic arthritis, and refractures. Dec 7th, 2017 the clavicle or collarbone os clavicula is located superior to the first rib and runs horizontally from the manubrium of the sternum to the acromion of the scapula. Nonoperative treatment of displaced shaft fractures may be associated with a higher rate of. Clavicle fractures are very common injuries in adults 25% and children 1015% and represent the 4466% of all shoulder fractures. Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use.
Do all clavicle fractures in children need to be managed by orthopedic surgeons pediatr emerg care. Trauma is the most common cause of a clavicle fracture. Clavicle fracture introduction clavicle fractures are a common orthopedic injury, particularly among infants and young children. A pseudoiatrogenic case of medial clavicular fracture springerlink. The purpose of this study was to examine the complication pro. The broken clavicle or collar bone four myths you need. Undisplaced fractures of both the diaphysis and the lateral end of the clavicle have a high rate of union, and the functional outcomes are good after nonoperative treatment. Fractures of the clavicle are more common in children, cyclists, rugby players and football players. The clavicle, also known as the collarbone, is the bone that connects the sternum and the shoulder blade. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. The incidence of fractures of the clavicle in adults appears to be increasing because of several factors, including the occurrence of many more highvelocity vehicular injuries and the increase in popularity of contact sports. Feb 03, 2020 a clavicle fracture is a break in your clavicle collarbone. Millett, md, msc steadman philippon research institute, vail, co, usa clavicle fractures are common in adults and children. Clavicle fractures are classified according to the fracture location with the use of the allman classification.
Simple pain medication is often needed, and should be given regularly until comfortable. Operative and nonoperative treatment of clavicle fractures. Clavicle fracture free download as powerpoint presentation. An arm sling should be worn for comfort for two to three weeks figure 2. Pdf clavicle fractures is there a standard treatment. Midshaft fractures 6982 per cent, lateral fractures 2128 per cent medial fractures 23 per.
Fractured clavicle the student health provider has diagnosed a fracture break of your clavicle collarbone. Support yourself by placing the opposite hand on a chair, table, or counter as shown. The fracture generally occurs in the middle of the bone figure 1. It articulates with the acromion process of the scapula laterally, at the. Pdf clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all. If you would like a large, unwatermarked image for your web page or. Many of these will require surgical correction and thus also require anesthesia. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Handbook of fractures pdf latest edition free download ebook. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks. Clavicle nonunion and plate breakage after locking compression.
The clavicle itself acts as a strut between the scapula and the sternum, transferring impact forces to the axial skeleton. Clavicle fracture broken collarbone orthoinfo aaos. After completion of this video session, it is expected that you will be able to. Dec 7th, 2017 the clavicle or collarbone os clavicula is located superior to the first rib and runs horizontally from. Review article management of distal clavicle fractures. Pdf clavicular fractures account for 510% of all fractures and over 30% of shoulder injuries. Sep, 2017 a variety of complications can be associated with clavicle fractures, regardless of the form of treatment. More than twothirds of cases are due to a fracture in the middle third of the clavicle group i of the allman classification.
The clavicle, or collarbone, is a long bone between the sternum breastbone and. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on. However, the optimal treatment option for isolated acute displaced midshaft. Displaced midshaft fractures were the most common type of clavicle fracture as well as the most. Orif with plate and screws of displaced middle third fracture of clavicle. Medial fractures are the least common type of clavicular fracture 210%. Clavicle fracture, internal fixation, locking plate, rockwood pin. The clavicle or collarbone is one of the most commonly broken bones in our body. Since the axial skeleton has more cartilage and bones, it can absorb much more force than the clavicle itself. However, radiographic nonunion after distal clavicle fracture has been reported in 10% to 44% of patients. Neer, c fractures of the clavicle fractures in adults. There is increasing evidence from level 1 prospective and or randomized trials that, for carefully selected patients, primary operative fixation of displaced clavicular fractures results in superior outcome. Fractures of the clavicle are common injuries accounting for between 2.
In adults this can be a much more troublesome injury. Yates orthopaedic registrar, chester royal infirmary summary most fractures of the clavicle unite without incident. Recent studies have demonstrated better outcomes with operative. Clavicle fractures are among some of the most common bone fractures seen in the medical community. The handbook of fractures pdf ebook is one document that every medical student and practitioner should carry around in their phone. Introduction in children the clavicle fractures easily, but it almost invariably unites rapidly and without complications. The index extremity is prepped and draped under sterile conditions, with the arm resting free across the body. No evidence to support figure of 8 bandage or brace. Lean forward at the waist, letting your arm hang freely. Open reduction is also indicated for fractures of the outer end of the clavicle. Explain why the clavicle commonly fractures fracture of the clavicle applied anatomy video.
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