Kevin shea, intermountain orthopaedics, boise, idaho the treatment for clavicle fractures continues to. The pectoralis major and deltoid originate from the clavicle and the trapezius inserts on it. 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. Age and genderspecific characteristics of the clavicular fractures, data from 83 hospitals in china song liu 1,2, bo liu, hengrui chang1,2, wei chen 1,2, yanbin zhu, yingze zhang1,2 1department of orthopaedic surgery, the hird hospital of hebei medical university, shijiazhuang 050051. The risks of surgery for both shoulder separation and clavicle fractures involve potential damage to the blood vessels and the lung that lie very close to the structures being repaired. 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. Treatment the fracture was addressed utilizing an acumed locking 8hole distal. Simple pain medication is often needed, and should be given regularly until comfortable. This feature is very helpful particularly in nonunions or malunions when.
Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. The most common place for an adult to break this bone is in the shaft, or middle third, of the bone. The clavicle overlies the brachial plexus, as well as the jugular and subclavian blood vessels. This essentially connects your arm to the rest of the body. During arm elevation, the clavicle, with respect to the thorax, undergoes elevation 11 to 15 and retraction 15 to 29. Sports participation and radiographic findings of adolescents treated nonoperatively for displaced clavicle fractures. There is increasing evidence from level 1 prospective and or randomized trials that, for carefully selected patients, primary. Since its introduction, surgeons have utilized the acumed locking clavicle plate system to solve many complex injuries of the midshaft and distal clavicle. Lean forward at the waist, letting your arm hang freely.
Historically, general consensus was that the vast majority of clavicle fractures heal well without operative. Clavicle fractures also called simply broken collarbones are a familiar woe to many athletes. Clavicle fractures are very common injuries in adults 25% and children 1015% and represent the 4466% of all shoulder fractures. Fractures of the clavicle j bone joint surg am 2009. Future studies on clavicular shaft fractures will require randomized control trials to settle the debate if operative treatment is the standard of care for displaced shaft fracture in adults. If you continue browsing the site, you agree to the use of cookies on this website. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Ageand genderspecific characteristics of the clavicular fractures. Millett, md, msc steadman philippon research institute, vail, co, usa clavicle fractures are common in adults and children. The clavicle is a unique bone that ossifies first in the human body after the 5 th month of fetal development 7. The collar bone or clavicle is a bone which is located between the shoulder and the sternum or breast bone and is the most commonly fractured bone seen in the clinic. Complications associated with clavicular fracture ceconnection.
Most common approximately 80% in both adults and children. A forceful impact to the shoulder area during a motor vehicle collision, a fall, or sports can break the clavicle. Once the plate shaft is placed on the clavicle, the end of the hook should be in contact with the underside of the acromion. An acumed 10hole precontoured locking superior clavicle plate was used to reduce the clavicle malunion after the callus was taken down.
Give parent fracture of the clavicle collarbone fact sheet. If there is difficulty lowering the plate shaft onto the clavicle, then the plate with 18 mm hook depth should be used. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Clavicle fracture broken clavicle broken collar bone. The clavicle bone, also known as the collarbone, is one of the most exposed bones. Nonunion midshaft clavicle fracture with allograft. Displaced fractures of the clavicle generally do well with nonoperative treatment nonunion rate clavicle require no treatment the only fractures of the clavicle that do not heal are the ones that you operate on. Shortening, fracture location, and laterality were recorded along with demographic information. Pdf clavicular fractures account for 510% of all fractures and over 30% of shoulder injuries. Rehabilitation protocol adopted from the massachusetts general hospital sports physical therapy program and the american academy of orthopedic surgeons. Clavicular shaft fractures musculoskeletal medicine for. Clavicle fracture knowledge for medical students and. The clavicle see diagram is a long, thin bone located in the upper, front chest.
The deforming forces these muscles can produce on clavicular fracture must be considered. Complications of clavicle fractures treated with intramedullary. Rehabilitation protocol adopted from the massachusetts. An arm sling should be worn for comfort for two to three weeks figure 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. Jan 01, 2008 clavicle fractures constitute 5 to 10 percent of all fractures. Neer, c fractures of the clavicle fractures in adults.
Oct 26, 2018 let a broken collarbone heal naturally, or not. The clavicular fracture is a relatively common fracture, accounting for 210% of all fractures and 40% of those around the shoulder girdle. 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%. The stainless steel plates are low profile and precontoured with locking and nonlocking screw options in each plate.
A clavicle fracture is a break in your clavicle collarbone. Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. Complications can include a collection of air in the pleural space surrounding the lung pneumothorax, injury to the nerves or blood vessels in. Symptoms typically include pain at the site of the break and a decreased ability to move the. When ac joint is intact, scapular motion 3 planes, 2 translations is. When ac joint is intact, scapular motion 3 planes, 2 translations is synchronously coupled with arm motion by the clavicle biomechanics ludewig pm, et al. Newborns can experience a fractured clavicle as the result of a difficult birth. Pain at the clavicle or top of the shoulder, especially with shoulder movement. Despite the name, the collarbone isnt really in your neck. Clavicle fractures are common fractures that usually affect children and adolescents and typically occur from a direct fall onto the shoulder.
No evidence to support figure of 8 bandage or brace. Introduction clavicle one of the most commonly fractured bones 2. However, it is well recognized that not all clavicular fractures have a good outcome. Clavicle fractures are a common orthopedic injury, particularly among infants and young children. 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. Fractured clavicle the student health provider has diagnosed a fracture break of your clavicle collarbone. Feb 03, 2020 a clavicle fracture is a break in your clavicle collarbone. Many clinicians reserve operative treatment for open injuries, or those with significant skin tenting, and fractures in which the initial shortening is 20mm. The clavicle, also referred to as the collarbone, is a long bone. 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. Also known as clavicle fracture, broken collar bone, broken clavicle, fractured clavicle, fractured collar bone, collar bone fracture what is a clavicle fracture. The clavicle plate and screw system is a comprehensive set of plates, screws, and instruments designed to treat midshaft and distal clavicle fractures.
Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. Fractures of the clavicle are common injuries accounting for between 2. Most clavicle fractures occur from falls, sports injuries, or car accidents. For the most part, they have been historically treated conservatively with acceptable results. Jan 31, 2011 fractures of the clavicle le kim trong md. Clavicle fractures are among some of the most common bone fractures seen in the medical community. Confirm that the correct anatomic alignment of the. The clavicles of 2899 cadaveric skeletons were manually. Jul 15, 2014 fracture classification allman classification. Jan 02, 2020 how to relieve pain from clavicle fracture. Fractures joint replacement sports medicine clavicle fracture orif protocol dr.
Displaced or comminuted clavicle fractures are associated with complica tions. The exercises may be suggested for a condition or for rehabilitation. Broad arm sling to support limb for 2 weeks or until comfortable. Kevin shea, intermountain orthopaedics, boise, idaho the treatment for clavicle fractures continues to evolve in the united states and europe. The type i distal clavicle fracture did not have ligamentous injury and presented few problems long term. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks. Symptoms you may hear a snapping sound and feel immediate pain when the clavicle breaks. The clavicle, also known as the collarbone, is the bone that connects the sternum and the shoulder blade. Slideshare uses cookies to improve functionality and performance, and to provide you with.
You will be told when to start these exercises and which ones will work best for you. The patient with a fracture of the clavicle will usually give a good history of trauma to lead the physician to suspect the injury. Most fractures occur in the middle third, but can occur at either end. Clavicle fractures are associated with arthritis of the. Jan 18, 2012 clavicle fractures are very common injuries in adults 25% and children 1015% and represent the 4466% of all shoulder fractures. Clavicle suggestions for some daily stretches to start with at home. Pain at the clavicle or top of the shoulder, especially with.
A clavicle fracture is a partial or complete break in the clavicle or. The fracture generally occurs in the middle of the bone figure 1. This only occurs with approximately five percent of all clavicle fractures. Clavicle hook plates features dynamic compression screw holes accept 3. Outcome of plate and intramedullary fixation of displaced midshaft. It is the bone that goes from the top of your breastbone to your shoulder blade.
In a child this will take about 4 weeks to heal and in an adult about 6 to 8 weeks. Fractures of the clavicle are a common injury and most often occur in younger individuals. With regardto shoulder separation surgery, it is possible that the end of the clavicle will migrate upwardagain should healing be inadequate. A broken collarbone, or clavical, is a common sports injury and, traditionally, people let the break heal naturally. The type ii distal clavicle fracture demonstrates displace. The clavicles of 2899 cadaveric skeletons were manually inspected for evidence of fracture. Clavicle fractures are associated with arthritis of the glen. Do all clavicle fractures in children need to be managed by orthopedic surgeons pediatr emerg care. However, the optimal treatment option for isolated acute displaced midshaft. Many clinicians reserve operative treatment for open injuries, or those with significant skin tenting, and fractures in. Fractures of the clavicle are common, accounting for 2. Weakness, numbness, or tingling in your shoulder and arm.
Fractures of the clavicle are usually thought to be easily managed by symptomatic treatment in a broad arm sling. 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. The inner end of the clavicle joins the sternum breastbone. Klein, md kennedywhite orthopaedic center what is a clavicle fracture. Here are some examples of exercises for you to try.
Kreher, md, boston university, boston, massachusetts c lavicle fractures constitute 5 patient information. The pdf of the article you requested follows this cover page. Sean griffin weeks full time in sling avoid ir behind the back, lifting more than 12 lbs, and horizontal adduction. But, sometimes, surgery is best to maintain shoulder functionality and avoid later discomfort. 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.
Alan barber neer classified fractures of the distal clavicle into two types depending upon whether the coracoclavicular ligaments were torn. We finished taking a comparison with our survey in. Original article age and genderspecific characteristics. The curvature of the plate was used as a template to help restore the normal sshaped curve of the clavicle figure 2. Clavicle fractures matthew pecci, md, and jeffrey b. It is generally accepted that clavicle fractures in adults that are in good alignment or near anatomical position can be left to heal well in a sling or in a figure of 8 bandage. Millett, md, msc steadman philippon research institute, vail, co, usa. Most surgeons prefer nonoperative treatment of nondisplaced midshaft clavicle fractures.
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