clavicle fracture

Mechanism of injury :

• Direct traumatic impact or fall on the shoulder

• Direct impact to clavicle
• Fall on outstretched hand
• From fall on the side .
• Vigorous muscle contraction , seizures [rare] .
• Pathological fracture [rare] .
Mechanism of injury
 Allman classification : according to
site of fracture :
group 1: Fracture mostly occur in the
middle third of clavicle 80% .
group 2: The fractures of outer[lateral] third
is 15%
group 3: fracture of inner [medial] third 5% .
Why does the fracture occur in middle
third more ?
It is the thinnest part of the bone .

It is the junction of the tow main curves of

shaft .

Subjected to direct trauma from falls or

impacts, making it more prone to fractures .
common pattern of fractures of
clavicle are :
1 - Green stick fracture :
Common at the junction between
middle and outer third .
Common in children .
2 - Un displaced fracture in :
3 - Separation of bone end :
4 - With greater displacement :

• There is over lapping and shortening .

 Clinical presentation :

•
• Pain that increases with shoulder movement
Swelling
• Tenderness
• Bruising
• A bulge on or near the shoulder
• A grinding or crackling sound when you try to move
the shoulder
• Stiffness or inability to move the shoulder
Diagnosis :
- Clinical picture \ examination

• x-ray [AP view ].

• CT scan : useful for non union assessment .

• arteriography : if vascular injury suspected .

 Treatment :
The aim is to provide support for the weight
of the arm .
Fracture of clavicle unite with or without
treatment .
Healing occurs usually in 3-6 weeks .
It may be :
conservative or surgical .
 Conservative treatment :

Support the arm in a sling until the pain subsides , usually

1-3 weeks .

Figure of 8- bandage .

Clavicle ring .

Analgesics .
Surgical treatment :

Rarely indicated , except in :

- lateral one third fracture .
- presence of neurovascular injury .
- non union cases .

Internal fixation plate .