This video discusses the surgical and nonsurgical management of clavicle collar bone fractures. Exercises to regain shoulder motion and strength lost as a result of injury, surgery, and lack of arm use while healing are necessary before returning to sports. A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 3 april 2015 v1s. It articulate with sternum medially to form sternoclavicular joint. The collar bone is the most commonly fractured bone in the body.
However, complications have been reported after non surgical treatment, the most. Pdf clavicle fractures is there a standard treatment. Most common approximately 80% in both adults and children. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Rarely, clavicle fractures can occur from a direct blow or from a fall on an outstretched.
Its superficial location, its thin midshaft, and the forces trans. If the ends of the bone have not moved out of place, we might fit you with a sling to immobilize the arm while the bone heals. Most surgeons prefer nonoperative treatment of nondisplaced midshaft clavicle fractures. Most clavicle fractures heal nicely with conservative, nonsurgical treatment. Whilst they may be very painful, clavicle injuries are rarely serious and in most cases are managed. Nonoperative treatment of midshaft clavicle fractures in adults.
Closed treatment of displaced middlethird fractures of the clavicle gives poor results patientoriented outcome 31% poor 15% nonunion associated with shortening 2 cm. An arm sling, shoulder immobilizer, or figureofeight brace is usually recommended. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. If displaced, the lateral fragment is usually pulled down by weight of limb and the medial fragment tends to be displaced upwards by the action of the sternocleidomastoid muscle. The patient presented with severe prominence of the right shoulder. Clavicle fractures are common and easily recognized because of their subcutaneous position, as shown in the images below.
Displaced or comminuted clavicle fractures are associated with complica. Patient history the patient is a 38yearold male who sustained a fracture of the clavicle 18 months previous. If you continue browsing the site, you agree to the use of cookies on this website. Clavicle fracture what treatment does my child need. Clavicle fracture solutions case series treated with. The incidence of nonunion following non operative care of displaced midshaft fractures of the clavicle a number of recent studies of completely displaced, midshaft fractures of the clavicle reveal nonunion rates between 15% and 20% 5,6. This means that the bone remains correctly aligned.
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. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. Fractures of the clavicle are usually thought to be easily managed by symptomatic treatment in a broad arm sling. This is a very common fracture that occurs in people of all ages. Treatment is dependent upon where the fracture is in the bone and how severe the fracture is. This is due to the trauma from the fracture and from the surgery. Clavicle fracture treatment and repair everything you need to know. A clavicle fracture, aka broken collar bone, is a common injury usually caused a fall, direct blow or car accident.
The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated nonsurgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. Basics anatomy first to ossify last to close 2125 yo 80% of growth is medial rotates 50 along its long axis elevates 30 mechanism 90% direct blow ends most medial injuries are physeal fractures until proven otherwise lateral physeal fractures are often mistaken for ac joint injuries. Clavicle fractures are very common injuries in adults 25% and children 1015 % 1 and represent the 4466% of all shoulder fractures 2. Clavicle fracture broken collarbone orthoinfo aaos. Broken collarbones are most common in children in young adults. Initial treatment consists of ice, compressive dressing, and medication to relieve pain and reduce swelling.
Operative treatment is best suited for more complicated fractures of the middle third of the clavicle. Millett, md, msc steadman philippon research institute, vail, co, usa clavicle fractures are common in adults and children. Rehabilitation protocol adopted from the massachusetts general hospital sports physical therapy program and the american academy of orthopedic surgeons. Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2. Even displaced fractures have been successfully managed without surgery. Clavicle fracture broken collarbone aurora health care.
Large multicentre studies of clavicle fractures have so far been missing. Pdf clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2 find, read. A clavicle fracture is typically associated with extreme pain, and arm movement is difficult. An arm sling should be worn for comfort for two to three weeks figure 2. Any nondisplaced distal clavicle fracture in a child type i, ii, or iii can be managed with sling immobilization for comfort and early rangeofmotion exercises as soon as pain permits. Clavicle fractureshaft childrens hospital at montefiore. In these cases, the bones need to be moved and secured in order to heal properly. Trauma is the most common cause of a clavicle fracture. Swelling and tenderness directly on the clavicle how is it diagnosed. Treatment will depend on the damage and the kind of fracture you have. Clavicular fractures are common injuries, accounting for 2. Ellipse denotes a minimally distal clavicle fracture. Clavicle fractures are most common in children and young adults, typically occurring in per sons younger than 25 years.
On occasion, a severe fracture, or what appears to be a mild fracture, will not heal properly. The fracture generally occurs in the middle of the bone figure 1. The clavicle, also referred to as the collarbone, is a long bone located at the top of the chest. These fractures generally heal well with rest and time. The majority of clavicle fractures can heal without surgery. The goal of management is to provide support for the shoulder. Is an sshape long, curved,tubular bone, lies horizontally a cross the root of neck. This leaflet gives you the advice and exercises to help your clavicle collar bone to recover after your fracture. The treatment of clavicle fractures can be divided into conservative no operation or operative.
Surgical treatment in displaced fractures of the clavicle in our study produces satisfactory results. Historically, nonoperative treatment of midshaft clavicular fractures was. Give parent fracture of the clavicle collarbone fact sheet. 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. If surgery is necessary, the bone is secured with surgical hardware, such as plates and screws. However, it is well recognized that not all clavicular fractures have a good outcome. Broad arm sling to support limb for 2 weeks or until comfortable. Clavicle surgery may be needed if the fractured bones if the fractured pieces of bone are not in their correct, anatomical location. At first your shoulder will feel stiff and painful but it is important that you continue to move it as this will aid your.
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. Normally, a sling is applied to the arm for treatment of a fractured clavicle. The fracture usually happens in the middle of the bone figure 1. Most common site of injury is middle third and least common is medial third. Complications can include a collection of air in the pleural space surrounding the lung pneumothorax, injury to the nerves or blood vessels in. Nondiaphyseal fracture 4% 18 years old 5% pathologic fracture fracture 5% ac joint injuries distal fracture 11 neurologicneurocognitive disorder 1% metabolic bone disorder 90 days or no xray 7% would not participate 65%. This type of fracture is fairly commonaccounting for about 5 percent of all adult fractures. Clavicle collar bone fracture collar bone fracture 12 years what has happened to my child.
When examining a patient with an acute clavicle fracture i typically look for the usual deformity of the. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks. Jul 15, 2014 fracture classification allman classification. Clavicle fracture broken collarbone a broken collarbone is also known as a clavicle fracture. Injuries of shoulder girdle clavicle fracture scapula fracture 2. Mathes expect swelling and bruising for a few weeks following the surgery. Jan 14, 2019 clavicle fractures are common and easily recognized because of their subcutaneous position, as shown in the images below. Physiotherapy department helping your clavicle to recover. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. You may be given contrast liquid to help the fracture show up better in the pictures. Fracture union usually progresses regardless of the treatment initiated. Initial visitanteroposterior, grashey, and yviews of the left shoulder. Pain will subside after 2 to 4 weeks, and you will be. Evaluation of the xray should include the location of the fracture medial, middle, or lateral third, the amount of displacement a percentage of the clavicle shaft diameter, the amount of fracture shortening overlap, angulation and whether or not the fracture involves either the medial physis or lateral physis.
Conservatively treated clavicle fracture healing with malunion. Clavicle fracture introduction clavicle fractures are a common orthopedic injury, particularly among infants and young children. Anatomy the clavicle is a long bone located on the upper chest. Refrain from sporting activities until the fracture is healed, usually 6 or more weeks. Displaced fractures of the clavicle generally do well with nonoperative treatment nonunion rate clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2.
Rehabilitation protocol adopted from the massachusetts. Functional outcomes of conservatively treated clavicle fractures. Displaced, clavicle fracture, mid shaft and plating. This prevents displacement and makes type ii fractures in children more stable than in adults. Jan 01, 2008 the usual mechanism of a clavicle fracture is a fall directly on the shoulder with the arm at the side. Jan 14, 2019 given the excellent results obtained with nonoperative treatment of uncomplicated midclavicular fractures, such therapy, using a figureofeight brace or regular support sling, is recommended. Jan 31, 2011 fractures of the clavicle le kim trong md. Clavicle fractures may be conservatively treated with acceptable. Treatment for a clavicle fracture depends on the injury. No evidence to support figure of 8 bandage or brace.
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