This leaflet gives you the advice and exercises to help your clavicle collar bone to recover after your fracture. Medial clavicle fractures are uncommon injuries, accounting for 23% of all clavicle fractures 1, 2. Clavicle fracture broken collarbone orthoinfo aaos. Navigate to learn more about shoulder fracture protocol. 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. Distal clavicle fractures have a high nonunion risk 2250% in patients treated nonsurgically due to the instability caused by the two opposing forces of trapezius traction and the weight of the upper extremity 1,2,3. Factors that may increase a risk for a clavicle fracture include the newborn being large in size, the newborns shoulder getting stuck during delivery, a narrow birth canal, or the use of tools to assist with the delivery. Most surgeons prefer nonoperative treatment of nondisplaced midshaft clavicle fractures. Proximal end clavicle fracture from a parachute jumping injury. Most medial clavicle fractures have traditionally been treated conservatively 1, 3, 4.
We look at symptoms, causes and treatment including top tips on making a full recovery. This is due to the trauma from the fracture and from the surgery. Factors that may increase the risk for a clavicle fracture include the newborn being large in size, the newborns shoulder getting stuck during delivery, or the use of tools to assist with the delivery. Swelling and tenderness directly on the clavicle how is it diagnosed. Is an sshape long, curved,tubular bone, lies horizontally a cross the root of neck. This recommendation is based on the analysis of 2000 patients with a very low nonunion rate of 0. The basic method to check for a clavicle fracture is by an xray of the clavicle to determine the fracture type and extent of injury. Most common approximately 80% in both adults and children. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Clavicle collar bone fractures are the most common injury sustained by newborns during birth. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patients activity level. One is surgical and the other is nonoperative treatment. After full recovery prescribe special exercises for clavicle fracture, help restore lost muscle mass and motor activity of the hands.
The clavicle, also referred to as the collarbone, is a long bone located at the top of the chest. It articulate with sternum medially to form sternoclavicular joint. This is largely because of reported nonunion rates of less than 1% and separate reports by neer40 and. 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. Conservative treatment sling or figureofeight bandage ensures a high union rate and a good clin ical result in the majority of cases 2,17. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. To compare fracture distribution and treatment in monotrauma and polytrauma patients with a clavicle fracture. Injuries of shoulder girdle clavicle fracture scapula fracture 2. Although extensive research for the optimal treatment of clavicle fractures has been performed, comparative studies between monotrauma and polytrauma patients are lacking. 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. Fracture union usually progresses regardless of the treatment initiated. Department of orthopaedic surgery, the 175th hospital of pla the affiliated southeast hospital of xiamen university, orthopaedic trauma center of pla, zhangzhou, 363000, pr china. Acute management of clavicle fractures a long term functional. This is a very common fracture that occurs in people of all ages.
Whereas many midshaft clavicle fractures can be treated nonsurgically, recent evidence suggests that more severe fracture types exhibit higher rates of symptomatic nonunion or malunion. This type of fracture is fairly commonaccounting for about 5 percent of all adult fractures. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. Surgical treatment for unstable distal clavicle fracture. A surgery is required in cases where there are multiple pieces of the bone, or there is a penetration in the skin leading to what is called an open fracture. Treatment will depend on the damage and the kind of fracture you have.
Shoulder fracture aurora clavicle fracture treatment denver. Clavicle fracture an overview sciencedirect topics. Jan 31, 2011 fractures of the clavicle le kim trong md. Jun 28, 2019 medial third clavicle fractures are rare injuries, with limited information available on their characteristics or treatment results. Rehabilitation protocol adopted from the massachusetts general hospital sports physical therapy program and the american academy of orthopedic surgeons. The aim was to find out, if the results could be generalized to daily practise, and assess the reliability of evidence. Nondisplaced clavicle fractures of whatever location are usually managed nonoperatively 2, 3. The evaluation is based on the literature published on clavicle fractures since 1965 to end of january 2007.
Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on. Electronic searches of the medline, embase and cochrane databases were performed. Baron dupuytren was the first to plead for a more rational approach to the treatment of fractures of the clavicle.
Rehabilitation protocol adopted from the massachusetts. Anatomy the collarbone clavicle is located between the ribcage sternum and the shoulder blade scapula, and it connects the arm to the body. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks. After open reduction and internal plate fixation, all symptoms were resolved and complete consolidation of the fracture was. Most clavicle fractures heal nicely with conservative, nonsurgical treatment. Jan 14, 2019 clavicle fractures are common and easily recognized because of their subcutaneous position, as shown in the images below. Handbook of fractures pdf latest edition free download ebook. 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. Nonoperative treatment of midshaft clavicle fractures in. David geier is an orthopedic surgeon and sports medicine specialist in charleston, south carolina. Treatment of distal clavicle fractures using a scorpion plate. Large multicentre studies of clavicle fractures have so far been missing. Pdf clavicle fractures is there a standard treatment.
The goal of clavicle fracture treatment is to achieve bony union while minimizing dysfunction, morbidity, and cosmetic deformity. The high rate of nonunion makes surgical intervention necessary for a distal clavicle fracture. Due to the curved shape in a tilted plane xrays are typically oriented with 15 upwards facing tilt from the front. E ight to ten per cent of a11 fractures occur in the clavicie, and probabiy there is no other bone the fracture of which causes. Jul 15, 2014 fracture classification allman classification.
Clavicle fracture introduction clavicle fractures are a common orthopedic injury, particularly among infants and young children. 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. We assessed and compared the outcomes of operative and nonoperative treatment for acute clavicle fractures in adults. Further literature was gathered regarding the surgical treatment of these.
In former times, xrays were taken of both clavicle bones for comparison purposes. Pdf clavicle fractures, especially of the mid third, are an injury commonly seen in clinical practice, therefore, there is constant earnest. Treatment of distal clavicle fractures using a scorpion. Although the indications for surgical fixation of midshaft clavicle fractures remain controversial, they appear to be broadening. At first your shoulder will feel stiff and painful but it is important that you continue to move it as this will aid your. Fractures were classified by the robinson classification.
Kreher, md, boston university, boston, massachusetts c lavicle fractures constitute 5 patient information. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. Clavicle surgery may be needed if the fractured bones if the fractured pieces of bone are not in their correct, anatomical location. Aggressive treatment is recommended for medial end clavicle fracture in case of displacement and facilitates rapid.
Historically, the vast majority of clavicle fractures have been treated nonoperatively in the acute setting. When examining a patient with an acute clavicle fracture i typically look for the usual deformity of the. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Mathes expect swelling and bruising for a few weeks following the surgery. There are 2 basic ways for treating a clavicle fracture. You may be given contrast liquid to help the fracture show up better in the pictures. Newborn clavicle fractures nationwide childrens hospital. Clavicle fracture broken collarbone a broken collarbone is also known as a clavicle fracture. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate. Introduction clavicle fracture is one of the most common. Therefore, for unstable distal clavicle fractures classified as neer type ii or v 4, 5, surgical treatment is usually indicated. Trauma is the most common cause of a clavicle fracture. A 49yearold man with a 15yearold nonunion of a midshaft clavicle fracture suffered from progressive tingling in his entire arm and fingers for two years, due to irritation of the brachial plexus in the costoclavicular space, especially upon elevation of the arm.
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. This prevents displacement and makes type ii fractures in children more stable than in adults. Normally, a sling is applied to the arm for treatment of a fractured clavicle. Pdf treatment of clavicle fractures giovanni merolla. Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 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. In these cases, the bones need to be moved and secured in order to heal properly.
Clavicle fractures account for 5% to 15% of childhood fractures, and are the most common type of fracture in children. Give parent fracture of the clavicle collarbone fact sheet. Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. Distribution and treatment of clavicular fractures in. Patients were divided into early 45 patients and delayed 60 patients treatment groups based on the timing of the surgical intervention within or after 7 days. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 3 april 2015 v1s.
Now that you are using your sling less, it is very important that you use your shoulder as normally as possible. If treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate. A clavicle fracture aka broken collarbone is a common shoulder injury. A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. Clavicle fractures matthew pecci, md, and jeffrey b. Nonoperative treatment of midshaft clavicle fractures in adults. If you continue browsing the site, you agree to the use of cookies on this website. Most fractures of the medial or lateral end of the clavicle can be treated nonsurgically if fracture. May 20, 2019 collarbone clavicle fracture an easy to understand guide covering causes, diagnosis, symptoms, treatment and prevention plus additional in depth medical information. Physiotherapy department helping your clavicle to recover. Jan 01, 2008 the usual mechanism of a clavicle fracture is a fall directly on the shoulder with the arm at the side. Operative treatment of these fracture is usually considered for open injuries, and fractures with neurovascular compromise or overlying skin compromise 5, 6. This report presents the outcome of a simple surgical method using a.
Dr adam seidl offers treatment for shoulder fractures and clavicle fracture in denver and aurora. Principally fractures of the clavicle can be treated by conservative and surgical means. Clavicle fractures are common and easily recognized because of their subcutaneous position, as shown in the images below. 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 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. On occasion, a severe fracture, or what appears to be a mild fracture, will not heal properly.
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