Traumatic Conditions (Fractures): Clavical Fracture

The clavicle is one of the most common bones to be fractured, most often in the middle third.

Children are particularly prone to the fracture, and newborns may present with a clavicle fracture following a difficult delivery.

The sterno-mastoid raises the proximal part of the fracture, and the weight of the upper limb causes the shoulder to drop.

Clavicle fracture

In this x-ray the clavicle fracture is obvious. However, the associate fractured ribs and pneumothorax were missed, as the eye is readily drawn to one injury, resulting in the assumption that no other injury is present.

Pathalogical fracture

Pathological fractures are not very common in the clavicle. In this x-ray the moth-eaten nature of the bone is obvious.

Treatment

Treatment of the uncomplicated fracture is generally to provide a sling, analgesia, and allow the bone to heal itself, monitoring progress with x-rays every week or few weeks.

Under what conditions would surgery be employed?

Surgery is employed in a minority of cases, when one or more of the following conditions presents:

• Wide separation of the fracture ends (suggests soft tissue interposition)
• Significant shortening of the clavicle of 2cm or more
• Skin penetration
• Associated neurological or vascular injury
• Non-union after 3-6 months