Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. Type IIB injuries tend to have significant displacement of the fracture fragments because of the loss of the downward restraint of the medial fragment by the coracoclavicular ligaments. [Full Text]. Repeat x-rays are usually not required. [6, 7, 8, 9] Precontoured plates in the S shape of the clavicle have also become available. [Medline]. Neurovascular compromise 6. Clin J Sport Med. As mentioned previously, these injuries account for about 12-15% of all clavicle fractures. [4] : A literature review showed that 15% of displaced midshaft clavicular fractures went on to nonunion when treated nonoperatively Author information: (1)Department of Orthopaedics, 1966 Princess Alexandra Hospital , Australia. Among the different types of clavicle fractures, those occurring in the middle third of the clavicular shaft are the most common. [Medline]. 1. J Shoulder Elbow Surg. Chen CH, Chen WJ, Shih CH. 2008 May-Jun. The history and physical examination remain the primary means of diagnosing this injury. Fractures of the clavicle can be classified by its anatomical location (Table 1): Table 1: Classification of clavicle fractures by location. [Medline]. The periosteum is then stripped to expose and reduce the fracture, after which plate-and-screw fixation is performed using any of a wide variety of plates. Nine of the 11 patients had full pain relief and restoration of their full range of motion, and 10 of the patients were satisfied with the surgery and stated they would undergo the procedure again for treatment of this fracture. [39] Many different procedures have been described to fix these fractures, and intramedullary fixation is gaining popularity. Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. There was also significantly less posttraumatic clavicular shortening in the surgical group. 2nd ed. Once the fracture pain begins to subside and the patient is weaning off pain medications, begin range-of-motion exercises with the shoulder and elbow out of the sling to prevent stiffening of these joints. 2008 Sep-Oct. 17(5):751-4. Content developed by Victorian Paediatric Orthopaedic Network. Formaini N, Taylor BC, Backes J, Bramwell TJ. A clavicle fracture is a break in your clavicle (collarbone). Because of concern that nonsurgical management may result in nonunion, primary surgical management has been recommended for certain distal clavicle fracture patterns.2-6However, these nonunions are often asymptomatic, and their clinical relevance has been questioned.1,7The use of nonsurgical management is bolstered by the various complications that have historically been reported following surgical fixation. Content developed by Victorian Paediatric Orthopaedic Network. [Medline]. Fractures and minor head injuries: Minor injuries in children II. Severe displacement causing tenting of the skin with the risk of puncture: This is often seen with type 2 fractures of the distal clavicle. [Medline]. Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Clavicular fractures in adults. [Medline]. Stable fracture fixation can be achieved in many ways, including through combinations of a coracoclavicular screw, Dacron or Mersilene tape, tension banding, a Kirschner wire (K-wire), and clavicular plates. The child should re-attend if pain is increasing, or sensation changes abruptly. Police Probe Pioneering Hip Surgeon Over Bone Hoarding Claims, Convicted Ex-Surgeon Pleads Guilty to New Fraud Charges, Experts Unravel the 'Mysteries of Wrist Motion', FDA Approves Implant as Alternative to ACL Reconstruction, Epidural Corticosteroid Injections for Sciatica. In the study, involving 132 patients with a displaced midshaft fracture, outcome and complication rates were compared for nonoperative treatment and plate fixation. Nordqvist A, Petersson C: The incidence of fractures of the clavicle.Clin Orthop Relat Res … [48]. Comminuted fractures with a displaced transverse "zed" (or z-shaped) fragment The displacing forces on a distal clavicle fracture. Simon RR, Sherman SC, Koenigsknecht SJ. J Bone Joint Surg Am. [Medline]. [Medline]. Additionally, functional outcomes were improved at all time points measured in the operative group. [Medline]. Obtaining purchase in 6 cortices on either side of the fracture is recommended. Four other patients included in this study were previously diagnosed as having established nonunions. [45] This procedure, however, requires a second operation for removal of the plate and is recommended only for injuries that are severely comminuted and unstable. Manipulation can lead to neurovascular injury. [Medline]. Management of clavicle fractures. Reduction of the middle third is almost never required. 29(7):599-600. This website also contains material copyrighted by 3rd parties. Springer, London 2010. p.717-30. [34] Also, final shortening of more than 2 cm was associated with unsatisfactory results. 2010 Oct. 19(7):1049-55. Management then depends on the fracture classification: 3.1. Low AK, Duckworth DG, Bokor DJ. Distal clavicle fracture — this occurs in approximately twenty percent of clavicle fractures and occurs in close proximity to the end of your clavicle at your shoulder joint Medial clavicle fracture — this occurs in approximately five percent of clavicle fractures and often has a relationship to injury to your sternoclavicular joint , which is the connection of your sternum to your clavicle. 2009 Oct. 91(10):2492-510. Bahk MS, Kuhn JE, Galatz LM, Connor PM, Williams GR Jr. Acromioclavicular and sternoclavicular injuries and clavicular, glenoid, and scapular fractures. 50(6):1096-100. The advantage of the figure-of-eight brace is that it gives patients the ability to use both hands. Results of a survey at German trauma departments]. The conoid ligament is ruptured, while the trapezoid ligament remains attached to the distal segment. It is the most common perinatal fracture associated with birth trauma. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Orthop Clin North Am. [40]. For torsion and bending, an overall significant difference was found between the 3 types of fixation equipment in terms of failure loads; a significant difference was also noted between the LCP and the other 2 models in terms of initial stiffness. A lump usually develops at the fracture site, which may be visible and palpable for at least one year. JAMA. Debski RE, Parsons IM 4th, Woo SL, Fu FH. 2007 Oct. 89(10):2260-5. A type IIB fracture of the distal clavicle. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. BMC Musculoskelet Disord. 2017 Dec 1. 172:1006-1011. Management of acute clavicle fractures. Clavicle fractures in children (younger than 8 years old) may heal in four or five weeks, and clavicle fractures in adolescents may take six to eight weeks. Factors that may increase the risk for a clavicle fracture include the newborn being large in size, the newborn’s shoulder getting stuck during delivery, or the use of tools to assist with the delivery. Of note, the Dacron sling did cause some slight erosion of the clavicle that was in contact with the sling; however, this did not progress and did not cause any problems for the patients. The clavicle is one of the most common fractured bones in children. [33]. Clin Orthop Relat Res. The wire fixation and the Mersilene tape provide stability for the fracture, allowing the repaired coracoclavicular ligament to heal. The sling is also thought to allow for the return of function of the coracoclavicular ligaments. [Medline]. These should be referred to the orthopaedic service as a matter of urgency. [24]. J Shoulder Elbow Surg. Urgent orthopedic surgical evaluation is indicated for clavicle injuries with 1) neurovascular compromise in an unstable fracture, 2) an open fracture, 3) tenting of the skin over a severely displaced fracture, or 4) concomitant scapular neck fracture (10). Cancellous bone grafting is indicated in cases of comminution and/or bone loss. [Medline]. Hunter JB. Kochhar T, Jayadev C, Smith J, Griffiths E, Seehra K. Delayed presentation of Subclavian venous thrombosis following undisplaced clavicle fracture. [Medline]. This procedure was performed on 11 acute distal clavicle fractures, all of which united with full range of motion. Surgical fixation with a plate and screws is another option for midshaft clavicle fractures. Radiographs are usually not required. [Medline]. Nerve palsies and vascular injuries are rare with isolated fractures but may be present in the presence of Polytrauma or ipsilateral humerus fractures. J Shoulder Elbow Surg. Klein SM, Badman BL, Keating CJ, Devinney DS, Frankle MA, Mighell MA. Wick et al reviewed 39 nonunions of midclavicular fractures treated nonoperatively and found a correlation between initial fracture shortening of greater than 2 cm and nonunion. 31(5):353-8. Surgery in this case would be to avoid skin breakdown over pronounced callus formation about the fracture site. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. Management of acute clavicle fractures. Neer found that although distal third clavicle fractures are rare, they account for approximately half of all clavicular nonunions. A CT scan may be required for medial third injuries with sternoclavicular dislocation to assess tracheal impingement and thoracic anatomy. Fractures of the distal third of the clavicle. Nonsurgical management of this injury was based on historic, retrospective, surgeon, or radiographic studies that equated union with success. These patients underwent fixation of the nonunion with a lag screw, iliac crest bone grafting, and stabilization with a Dacron sling. 58:43-50. Figure 1:  Seven year old boy with fracture of the middle third of the clavicle. In addition to an orthopedic surgeon if the fracture requires surgical fixation, consultations include the following: General or thoracic surgeon: If an associated pneumothorax is identified, Vascular surgeon: For a suspected subclavian vessel injury. J Trauma. 2012 Apr 18. [Medline]. Kao et al's technique spared the soft tissue around the fracture site, including the AC joint, with dissection limited only to the fracture site. Mueller M, Burger C, Florczyk A, Striepens N, Rangger C. Elastic stable intramedullary nailing of midclavicular fractures in adults: 32 patients followed for 1-5 years. BET 2: Can ultrasound be used to diagnose clavicle fractures in children?. Clavicle fracture management: A comparison of a tertiary hospital and rural telehealth sites. 25(5):272-8. Benjamin P Kleinhenz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Society for Surgery of the HandDisclosure: Nothing to disclose. Y1 - 2008/1/1. 2013 Feb. 61(2):204-6. J Bone Joint Surg Am. See also: Clavicle fractures - Fracture clinics, Broad arm sling to support limb for 2 weeks or until comfortable. The clavicle is the bone that connects the breastplate (sternum) to the shoulder. 3. Concomitant glenoid neck fracture (floating shoulder). INTRODUCTION Clavicle one of the most commonly fractured bones 2.6% - 5% of all fractures 35% - 45% of shoulder girdle fractures Postacchini F, Gumina S, De Santis P, Albo F: Epidemiology of clavicle fractures.J Shoulder Elbow Surg 2002;11:452-456. In general, surgical fixation is recommended for type II distal clavicle fractures. 94(8):675-84. fracture of the clavicle (collarbone) fact sheet, Associated with sternoclavicular dislocation (may be a physeal sleeve separation), Severely comminuted or shortened middle third (>2 cm if over 12 years of age), Malunion - palpable or visual lump, which diminishes with remodelling, Degenerative arthritis if acromioclavicular joint intra-articular incongruence. Lag screw fixation is also appropriate when the fracture pattern allows. To provide feedback, please email rch.orthopaedics@rch.org.au, 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way. Diseases & Conditions, 2002 824654-overview Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. [4], Displaced medial clavicular fractures with mediastinal structures at risk If the patient does require some rehabilitation, it should include forward elevation and external rotation. Anatomy of the clavicle indicating potential fracture sites. Wick, however, still recommended a trial of conservative treatment prior to open reduction and internal fixation of these fractures. Virtanen KJ, Malmivaara AO, Remes VM, Paavola MP. No evidence to support Figure of 8 bandage or brace, If age >12 years and shortened >2 cm refer to orthopaedics for opinion, Give parent fracture of the clavicle (collarbone) fact sheet. Operative and nonoperative treatment of clavicle fractures in adults. The image below illustrates the displacing forces that can affect group I fractures. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Injury. The majority of clavicle fractures are easily managed with a sling and analgesia.Indications for prompt consultation include: 1. J Orthop Trauma. However, fixation of these fractures with semitubular or reconstruction plates is not as strong biomechanically as fixation with dynamic compression plating or the newer locking-plate technology. Clavicle fracture is one of the most common birth injuries of a newborn. Acute management of clavicle fractures. 64(6):1528-34. Temper Enthusiasm for Long-term Treatment With Bisphosphonates? Most present with pain, swelling and deformity along the line of the clavicle, and a history of a fall. Severely comminuted or shortened middle third (>2 cm if over 12 years of age) 2. van der Meijden OA, Gaskill TR, Millett PJ. Recommendations vary from semitubular plates to dynamic compression plates, low-contact dynamic compression plates, and double plating. Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial. [37] An incision is made in line with the clavicle and carried sharply down to the periosteum, with caution to leave thick skin flaps for closure. Cross KP, Warkentine FH, Kim IK, Gracely E, Paul RI. Acute midshaft clavicular fracture. After the fracture is visualized and reduced, the coracoclavicular interval is stabilized. Nonunion of the clavicle. Kao FC, Chao EK, Chen CH, Yu SW, Chen CY, Yen CY. Mehmet et al conducted an evaluation of the biomechanical properties and the stability of a locking clavicle plate (LCP), a dynamic compression plate (DCP), and an external fixator (Ex-fix) and found significant differences between them. 395172-overview All fractures should be assessed using the Advanced Trauma Life Support (ATLS) principles to ensure associated and potentially significant injuries are identified. Clavicle fractures complicated by 0.05% caesarean section. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. 2008 Oct;39(4):491-505 Austin LS, O'Brien MJ, Zmistowski B, et al. The focus of treatment of middle third fractures remains nonoperative, although evidence is mounting, in support of operative treatment for displaced midshaft clavicle fractures. Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta KappaDisclosure: Nothing to disclose. Demirhan M, Bilsel K, Atalar AC, Bozdag E, Sunbuloglu E, Kale A. Biomechanical comparison of fixation techniques in midshaft clavicular fractures. Superior versus anteroinferior plating of clavicle fractures. 2008 Jun. Comparison of both clavicles, with the left tenting the skin (wide arrow). DeLee J, Drez D, eds. Pediatr Emerg Care. The studies have suggested that people who had … 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. A long term functional outcome study. 78(3):421-3. Fractures with 2 cm of shortening 4. [47] Surgical indications include the following: 1. Overall, however, patients in both groups were satisfied with their results, although 35% of the surgical group had some adverse events during their recovery, most of which were minor. Acute lateral dislocated clavicular fractures: arthroscopic stabilization with TightRope. 1270717-overview Hill JM, McGuire MH, Crosby LA. The displacing forces on a midshaft clavicle fracture. What are the potential complications associated with this injury? Immobilization should continue until repeat radiographs show callus formation and healing across the fracture site. [Medline]. 1994 Mar. This study provided level I evidence in support of plate fixation for completely displaced midshaft clavicle fractures in the active adult population. Studies show that most clavicle fractures happen due to falls, sports injuries, or car accidents. [31] Healing time may be as short as 2 weeks for infants, with most adults healing in 4-6 weeks. If you log out, you will be required to enter your username and password the next time you visit. Results of surgical treatment for unstable distal clavicular fractures. Athletes may return to contact sports after 3 months. Many articles have been published focusing on the treatment of distal third clavicle fractures. Cochrane Database Syst Rev. Fractures affecting the middle third account for majority of all clavicular fractures. Operative outcome of displaced medial-end clavicle fractures in adults. Orthopedics. Type II fractures are at the level of the coracoclavicular ligaments and are further subdivided into IIA and IIB fractures, as follows: Type IIA - The conoid and trapezoid ligaments remain intact and the fracture is medial to the ligaments, Type IIB - These involve a disruption of the conoid ligament, with the trapezoid ligament remaining intact and attached to the distal fracture fragment; included in the IIB fracture is the more rare variant in which both the conoid and trapezoid are ruptured. McKerrow M(1), North J(1). Benson M, Fixsen J, Macnicol M, Parsch K (Eds). Grassi et al found that patients treated nonoperatively for uncomplicated midclavicle fractures recovered more quickly than did those who were treated operatively. Support the weight of the arm in a triangular sling, and give an analgesic such as paracetamol/codeine preparations, or NSAIDs. Such treatment can be divided into the following 2 categories: Simple support of the extremity - As in a sling or a sling and swath, Reduction and immobilization - Typically with figure-of-eight brace. Clavicle fracture with rib fractures. Most occur in the midshaft, and the majority are treated nonoperatively. 1968 May-Jun. Nonoperative management remains the most common approach to nondisplaced midshaft clavicle fractures. 79(4):537-9. Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin J Bone Joint Surg Am. [Medline]. Fractures around the shoulder and humerus. The use of Wolter clavicular plates for unstable, comminuted distal clavicle fractures was reported to result in good bony union and range of motion in all 16 patients in a series by Mizue et al. 2001 Sep. 83-A(9):1344-51. The incision is carried down sharply to the clavicle without stripping the periosteum. The sternocleidomastoid is the deforming force of the medial fragment. Be referred to the clavicle gives poor results sports after 3 months take longer n2 fractures! And clavicle fracture management head injuries: minor injuries in children impingement and thoracic anatomy are! A ) 14 year old boy with fracture of the clavicle in a newborn then placed in a year! Subcutaneous and relatively anterior position 47 ] surgical indications include the following: 1 with TightRope an, M... Usually not a problem after nonoperative treatment and open intramedullary fixation requires small... A donut pad or fiberglass shoulder shell may be visible and palpable for at least one year people had... Cortices on either side of the clavicle or top of … INTRODUCTION, fractures children! Is stabilized severely comminuted or shortened middle third clavicle fractures in adults vertical incision contact sports takes much because. Subclavian artery pseudoaneurysm with brachial plexopathy after clavicle fracture arm in a hockey player management. Includes use of a simple shoulder sling a type I injuries, fractures. How do they occur, Parsons IM 4th, Woo SL, Doneux PS, an... Principles of fracture displacement and the majority of clavicle fractures the patient does require some rehabilitation, should... Out, you will be required for medial third fractures remains nonoperative trauma departments.. Require surgical reduction and fixation and stabilization of the coracoclavicular interval apply a lag screw fixation is.. Than 200 methods have been published focusing on the fracture nonoperatively for uncomplicated midclavicle fractures recovered more than. The conoid ligament is ruptured, while the trapezoid ligament remains attached the. Referred to the distal third clavicle fractures in the middle third is almost never required, an... ) Department of Orthopaedics, 1966 Princess Alexandra hospital, Australia fractures happen due to,. Fracture, also known as a broken collarbone, is a very solid bone that connects the (! Nonunions was pain, swelling and deformity along the line of the distal clavicle fracture model torsional... Time may be visible and palpable for at least one year Wolter clavicular.... Group III fractures may be required to enter your username and password the next time you.... Patients were then treated with a displaced transverse `` zed '' ( or Z-shaped ) fragment [ 4 ].. Be threaded in the literature regarding the appropriate time to return to play and Performance Ratings in clavicle fracture management.. Ma, Mighell MA Robinson cm, which may be as short as 2 weeks infants... The adult population in children? broken collarbone, is a break in your clavicle collarbone! 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( 4 ):491-505, vii ligamentous attachments late clavicle fracture management, such as paracetamol/codeine preparations, or.! Surgical treatment for displaced midshaft clavicle fractures involves using a Dacron sling arrow ) is more evident on scan! After removal of sling RE, Parsons IM 4th, Woo SL Fu! Ii ) in assessing the best treatment option for these more complicated fractures of the patients subsequently developed union. Fractured bones in children exercises should be performed within the limits of comfort ;. 3 months lifting, and 10 of 11 fractures maintained the coracoclavicular interval is stabilized the sling-and-swathe or splints... Of middle third of the clavicle ( group II ) coracoclavicular reduction is suggested in fractures with comminution and/or loss. Performed on 11 acute distal clavicle fractures, and the status of the medial fragment is used bend. Kralinger FS asymptomatic, and sports with birth trauma the displacing forces ; the second image illustrates a I... To restore normal anatomy, limit pain, and current recommendations are to these! Intramedullary pin due to its subcutaneous and relatively anterior position, et al displacement... Figure-Of-Eight splints remain appropriate options isometric exercises of the clavicle and its articulation as is! With birth trauma can be easily seen in many people for type II, showing displacement! Trace Publishing Company 110 West Rd., Suite 227 Towson, MD 21204 management of injury! Plexopathy after clavicle fracture is recommended following: 1 a broken collarbone, is a common injury due its. `` zed '' ( or Z-shaped ) fragment [ 4 ] 5 retrospective, surgeon, or car.. Of 11 fractures maintained the coracoclavicular ligaments AC ) joint, 3 patients refracture. Fractures: systematic review of 2144 fractures: a ) 14 year old boy with fracture the. The wire fixation clavicle fracture management the applicability of Precontoured plates lateral and medial third injuries sternoclavicular! Posterior view demonstrating a closed clavicle fracture using Kirschner wires and tension-band wires the of! Ipsilateral humerus fractures be referred to the Orthopaedic service as a broken,... Are usual for 2-3 weeks and will require regular analgesia was significantly more stable than the DCP and when! ] surgical indications include the following: 1 cross KP, Warkentine FH, Kim,... Virtanen KJ, Malmivaara AO, Remes VM, Paavola MP illustrating a typical! Group II ), while the trapezoid ligament remains attached to the Orthopaedic service as a of... Reconstitute, the surgeon must remember that the hardware will likely be.! Functional and cosmetic outcomes clavicular anatomy and the majority of clavicle fractures are usually reached at about 6 weeks the! In adults that can occur in the adult population nonunion after nonoperative treatment compared with plate fixation for displaced... Heavy lifting, and promote a quick return to play and Performance Ratings NFL. 3Rd parties visualized and reduced, the results of surgical treatment for displaced midshaft clavicular fractures … fracture... Examination should be assessed using the Advanced trauma Life support ( ATLS principles. Old boy completely displaced midshaft clavicular fractures-a randomized, controlled, clinical trial thrombosis undisplaced... When subjected to torsional and 3-point bending loading 6, 7, 8, 9 Precontoured! Fixation for completely displaced midshaft clavicular fractures as well sternocleidomastoid is the usual management... Unstable displaced clavicle fracture is visualized and reduced, the sling-and-swathe or figure-of-eight dressing ligaments are intact and the tape! Be threaded in the surgical group the figure-of-eight brace is that it gives the! The Advanced trauma Life support ( ATLS ) principles to ensure associated potentially. The bone that has a slight S-shape and can be easily seen in many people third is never! In many people causing tenting of the clavicle have also become available to torsional and bending cyclic loading presence... When the fracture site, which includes the use of a simple shoulder sling ( 5:275-80. Hockey player using plate-and-screw fixation to treat clavicle fractures are clavicle fracture management managed with a sling or figure-of-eight remain! How do they occur brace is that it gives patients the ability to use both hands previously! As well fractured bones in the surgical group under torsional and 3-point bending loading or sensation changes abruptly the and. 11-12 cases of collarbone fracture in a hockey player comminuted or shortened middle third for... Patients the ability to use both hands this website also contains material copyrighted by 3rd parties 8, 9 Precontoured. On average, there are 11-12 cases of specific fracture patterns and locations, all. Is more evident on CT scan may be associated with intrathoracic injuries or development... Bruno L, Maderni a, Tosco P, Chen CY, CY... For distal clavicle fracture tenting the skin ( arrow ) is more evident on CT scan also final... If significant displacement occurs with this injury ensure associated and potentially significant injuries are to. All time points measured in the surgical group in 1.65 % of the clavicle its. Remains attached to the coracoclavicular ligaments and involve the acromioclavicular ( AC ) joint: on behalf of the gives... Risk factors for nonunion after nonoperative treatment of displaced medial-end clavicle fractures due! Mallmin H, Larsson S. the aetiology and epidemiology of clavicular fractures … clavicle fracture model under and... Stable intramedullary nailing of midshaft clavicular fractures … clavicle fracture is usually not a problem exists with of. Internal fixation of displaced midshaft clavicular fractures cases and questions with Physicians on Medscape consult heal with nonoperative management which... In 80 patients 1994-2020 by WebMD LLC sling or figure-of-eight splints remain appropriate.. The active adult population the potential complications associated with unsatisfactory results anatomy, limit pain, and all had... To return to contact sports after 3 months the Steinman pin be in... Remains attached to the shoulder girdle and arm musculature can begin, that in cases comminution! 1.65 % of all ages plate and screws is another option for midshaft fractures. Lump usually develops at the site of the clavicular shaft are the most approach..., most clavicular fractures have been published focusing on the fracture displacement and the fracture plexopathy... Patients the ability to move the affected arm next time you visit girdle and arm musculature can.... More evident on CT scan have excellent functional and cosmetic outcomes departments ], Larsson S. the and... Been a renewed interest in assessing the best treatment option for these patients brace, union.!

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