Clavicle Fractures

Author: L Joseph Rubino, MD; Chief Editor: Mary Ann E Keenan, MD more... Updated: May 18, 2011

Background
Historically, clavicle fractures have been considered best treated nonoperatively, with good outcomes. Management typically included the use of either a shoulder sling or a figure-of-eight brace. The vast majority of these fractures healed, with variable amounts of cosmetic deformity. Studies have examined the different patterns of displacement and clinical outcomes of clavicle fractures according to their location. The images below illustrate clavicle fractures.

Type I fracture of the distal clavicle (group II). The intact ligaments hold the fragments in place.

A type II distal clavicle fracture. In type IIA, both conoid and trapezoid ligaments are on the distal segment, w hile the proximal segment, w ithout ligamentous attachments, is displaced.

A type IIB fracture of the distal clavicle. The conoid ligament is ruptured w hile the trapezoid ligament remains attached to the distal segment. The proximal fragment is displaced.

Medical literature has focused predominantly on fractures of the middle and lateral clavicle. The literature is still lacking concerning the management of medial clavicle fractures. According to current literature, medial clavicle fractures respond well to nonoperative management. Controversy remains concerning operative versus nonoperative treatment of middle and lateral clavicle fractures.[1, 2, 3]