CLAVICLE FRACTURE

Clavicle

The clavicle is responsible for bracing the shoulder girdle and propping it away from the sternum and the thoracic cage.

This strut function affordscosmesis and posture to the shoulder girdle.

The clavicle lies above several important nerves and blood vessels. However, these vital structures are rarely injured when the clavicle breaks, even though the bone ends can shift when they are fractured.

CLAVICLE FRACTURE

The mechanism of injury is:

• fall onto outstretched hand (sports injury)
• direct shoulder trauma (traffic accident)

The vast majority of fractures will result from a simple fall, a fall from a height, a fall during sports activity, or a motor vehicle accident.

The diagnosis of clavicle fracture is typically made on a single anteroposterior radiograph.



Shaft clavicle fracture.  The central part is upward due to sternocledomastoid tendon traction

Clavicle fractures can be very painful and may make it hard to move your arm.

Additional symptoms include:

•Sagging shoulder (down and forward)
•Inability to lift the arm because of pain
•A grinding sensation if an attempt is made to raise the arm
•A deformity or "bump" over the break
•Bruising, swelling, and/or tenderness over the collarbone

 

CONSERVATIVE TREATMENT
THERAPY: 

A simple arm sling or figure-of-eight wrap is usually used for comfort immediately after the break. These are worn to support your arm and help keep it in position while it heals.


A simple arm sling

A figure of eight wrap, extend the shoulde to facilitate the reduction of clavicle fracture.

You will need to see your doctor regularly until your fracture heals. He or she will examine you and take x-rays to make sure the bone is healing in good position. After the bone has healed, you will be able to gradually return to your normal activities.

OPERATIVE TREATMENT
THERAPY: 

If your bones are out of place (displaced), your doctor may recommend surgery. Surgery can align the bones exactly and hold them in good position while they heal. This can improve shoulder strength when you have recovered.

Indications:

  • great displacement of the fracture
  • nonunion
  • cosmesis
  • rough spikes of the bone fragments

During this operation, the bone fragments are first repositioned into their normal alignment, and then held in place with special screws and/or by attaching metal plates to the outer surface of the bone.

Plate and screws for the reduction and stabilization of the fractures sites.

The patient must remain to the clinic for 24 hours for medical care.

Plates and screws are usually not removed after the bone has healed, unless they are causing discomfort.