eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics

Fracture, Clavicle: Differential Diagnoses & Workup

Author: Amir Estephan, MD,, Resident Physician, Department of Emergency Medicine, Kings County Hospital Center, Brooklyn
Coauthor(s): Robert J Gore, MD, Clinical Assistant Professor, Attending Physician, Assistant Residency Director, Department of Emergency Medicine, Kings County/State University of New York Downstate Hospital
Contributor Information and Disclosures

Updated: Jul 28, 2009

Differential Diagnoses

Dislocations, Shoulder
Fractures, Rib
Pneumothorax, Tension and Traumatic
Rotator Cuff Injuries
Sternoclavicular Joint Injury

Workup

Imaging Studies

  • Routine clavicle radiography
    • Fracture is usually demonstrated on an anteroposterior (AP) view.
    • Apical lordotic views (an AP view with the tube directed 45° cephalad) may be required to define the degree of displacement.
    • Initial radiographs may appear normal despite suggestive clinical findings. In these instances, the arm should be immobilized in a simple sling, and the radiographs repeated in 7-10 days if symptoms persist.
  • CT scan may be required because routine clavicle radiographs may miss fractures due to overlap of surrounding structures, particularly at either end of the bone.

Also see, Clavicle, Fractures and Dislocations.

Other Tests

  • Other tests may be required when clinically indicated to assess the possibility of life-threatening associated injuries.
    • Chest radiography, if pneumothorax suspected
    • Angiography, if vascular injury suspected

More on Fracture, Clavicle

Overview: Fracture, Clavicle
Differential Diagnoses & Workup: Fracture, Clavicle
Treatment & Medication: Fracture, Clavicle
Follow-up: Fracture, Clavicle
Multimedia: Fracture, Clavicle
References
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References

  1. Simon RR, Koenigsknecht SJ. Clavicle fractures. In: Emergency Orthopedics: The Extremities. 5th ed. McGraw-Hill; 2007.

  2. Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. J Bone Joint Surg Am. Feb 2009;91(2):447-60. [Medline].

  3. Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev. Apr 15 2009;CD007121. [Medline].

  4. Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS. Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial. J Orthop Trauma. Feb 2009;23(2):106-12. [Medline].

  5. Pujalte GG, Housner JA. Management of clavicle fractures. Curr Sports Med Rep. Sep-Oct 2008;7(5):275-80. [Medline].

  6. Low AK, Duckworth DG, Bokor DJ. Operative outcome of displaced medial-end clavicle fractures in adults. J Shoulder Elbow Surg. Sep-Oct 2008;17(5):751-4. [Medline].

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Further Reading

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Keywords

clavicle fracture, clavicle fracture treatment, clavicular fractures, fractured clavicle, clavicula, collar bone, collarbone, displaced clavicle fractures

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Contributor Information and Disclosures

Author

Amir Estephan, MD,, Resident Physician, Department of Emergency Medicine, Kings County Hospital Center, Brooklyn
Amir Estephan, MD, is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Emergency Medicine Residents Association
Disclosure: Nothing to disclose.

Coauthor(s)

Robert J Gore, MD, Clinical Assistant Professor, Attending Physician, Assistant Residency Director, Department of Emergency Medicine, Kings County/State University of New York Downstate Hospital
Robert J Gore, MD is a member of the following medical societies: American College of Emergency Physicians, National Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Francis Counselman, MD, Program Director, Chair, Professor, Department of Emergency Medicine, Eastern Virginia Medical School
Francis Counselman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Association of Academic Chairs of Emergency Medicine (AACEM), Norfolk Academy of Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Tom Scaletta, MD, President, Emergency Excellence (EmEx) (www.emergencyexcellence.com); Assistant Professor of Emergency Medicine, Rush Medical College, Cook County Hospital; Chairperson, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine
Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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