Overview
How are clavicle fractures diagnosed?
What are the clinical signs and symptoms of clavicle fractures?
Which lab studies are performed in the evaluation of clavicle fractures?
Which imaging studies are performed in the evaluation of clavicle fractures?
How are most clavicle fractures managed?
When is surgery indicated in the treatment of clavicle fractures?
How are midshaft clavicle fractures managed surgically?
What are the surgical options for treatment of distal clavicle fractures?
What are the characteristics of clavicle fractures?
What is the maturation process for the clavicle?
How are clavicle fractures treated nonoperatively?
What are treatment options for clavicle fractures?
How are clavicle fractures categorized?
What are the types of distal clavicle fractures?
What are the subgroups of Neer type II distal clavicle fractures?
What anatomy is relevant to clavicle fractures?
What is the anatomical relationship between the clavicle and sternoclavicular (SC) joint?
What is the anatomical relationship between the clavicle and acromioclavicular (AC) joint?
Which muscles originate from the clavicle?
Which muscle insert on the clavicle?
What is the role of muscles in clavicle fractures?
Which structures in the anatomy of the clavicle may be injured with a fracture?
What is the pathophysiology of clavicle fractures?
What is the frequency of each type of clavicle fracture?
What is the pathophysiology of group I clavicle fractures?
What is the pathophysiology of group II clavicle fractures?
What is the pathophysiology of group III clavicle fractures?
What causes clavicle fractures?
What is a less common mechanism for clavicle fractures?
How common are clavicle fractures in children?
What is the prevalence of clavicle fractures in the US?
What is the annual incidence of clavicle fractures in the US?
What is the global annual incidence of clavicle fractures?
How does the incidence of clavicle fractures vary by sex?
How does the incidence of clavicle fractures vary by age?
What is the prognosis of clavicle fractures?
What are the risk factors for nonunion of clavicle fractures?
What is the nonunion rate for clavicle fractures?
What are the greatest risk factors for nonunion in clavicle fractures treated nonoperatively?
What is the role of risk factor assessment in the management of clavicle fractures?
What is malunion in clavicle fractures?
What causes neurovascular compromise in clavicle fractures?
Which intrathoracic injuries are associated with clavicle fractures?
What are possible complications of malunion in clavicle fractures?
What are possible complications of group III clavicle fractures?
What are possible life-threatening complications of clavicle fractures?
What information about clavicle fractures should patients receive at the initial visit?
What is included in the patient education information for clavicle fractures?
What information should parents be given about neonatal clavicle fractures?
Presentation
Which clinical presentations are characteristic of clavicle fractures?
What is the most common mechanism causing clavicle fractures?
What is included in the physical exam for clavicle fractures?
DDX
What are the diagnostic considerations for clavicle fractures?
What are the differential diagnoses for Clavicle Fractures?
Workup
Which studies are performed in the workup of clavicle fractures?
Which standard radiography views are used in the diagnosis of clavicle fractures?
What is the role of stress views in the diagnosis of clavicle fractures?
What are the radiographic appearances of clavicle fracture?
When are repeated radiographs indicated in the evaluation of clavicle fractures?
What is the role of chest radiographs in the diagnosis of clavicle fractures?
When are shoulder series radiographs indicated in the diagnosis of clavicle fractures?
What is the role of CT scanning in the diagnosis of clavicle fractures?
When is arteriography indicated for the diagnosis of clavicle fractures?
What is the role of ultrasonography for the diagnosis of clavicle fractures?
Treatment
What is nonoperative management of clavicle fractures?
What is the focus of treatment of clavicle fractures?
What is the incidence of nonunion of clavicle fractures?
Which specialist consultations may be needed for the treatment of clavicle fractures?
What are the surgical indications for the treatment of clavicle fractures?
What are the nonoperative treatment options for group I clavicle fractures?
How does bracing compare to a sling for the treatment of group I clavicle fractures?
What is the prognosis of group I clavicle fractures following treatment?
What is the efficacy of surgery of group I clavicle fractures?
How does fracture shortening in group I clavicle fractures affect treatment selection?
How is surgical fixation performed for group I clavicle fractures?
How is intramedullary fixation performed in the treatment group I clavicle fractures?
How is plate-and-screw fixation performed in the treatment of group I clavicle fractures?
What is the goal of treatment for group II clavicle fractures?
What are type I group II clavicle fractures?
What are the goals of treatment for type I group II clavicle fractures?
What are the subgroups of type II group II clavicle fractures?
How are type IIB group II clavicle fractures characterized?
What are the treatment options for group II clavicle fractures?
How is stable fracture fixation achieved in the treatment of group II clavicle fractures?
Why should orthopedic consultation for group II clavicle fractures happen quickly?
What is the role of Wolter clavicular plates in the treatment of group II clavicle fractures?
What is the role of surgery in the treatment of type III group II clavicle fractures?
What are the treatment options for group III clavicle fractures?
What is the role of physical therapy in the treatment of clavicle fractures?
What is the basis for return to play decisions for athletes following clavicle fracture?
What is the basis for return to play decisions in noncontact sports following clavicle fracture?
What is the basis for return to play decisions in contact sports following clavicle fracture?
Medications
What is the role of medications in the treatment of clavicle fractures?
Which medications in the drug class Antibiotics are used in the treatment of Clavicle Fractures?
Which medications in the drug class Analgesics are used in the treatment of Clavicle Fractures?
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A posterior view demonstrating a closed clavicle fracture tenting the skin (arrow), which can potentially lead to an open fracture.
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Comparison of both clavicles, with the left tenting the skin (wide arrow).
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Close-up view of clavicle tenting the skin (arrow).
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Comminuted fracture in a hockey player. Note the medial fragment tenting the skin.
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Additional view of fracture displacement and comminution in a hockey player. The sternocleidomastoid is the deforming force of the medial fragment.
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Radiographs after open reduction and internal fixation of a comminuted fracture in a hockey player.
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Anteroposterior view of middle third clavicle fracture illustrating a relatively typical fracture pattern.
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Anteroposterior view of distal clavicle fracture, type II, showing wide displacement.
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The displacing forces on a midshaft clavicle fracture.
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The displacing forces on a distal clavicle fracture.
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Type I fracture of the distal clavicle (group II). The intact ligaments hold the fragments in place.
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A type II distal clavicle fracture. In type IIA, both conoid and trapezoid ligaments are on the distal segment, while the proximal segment, without ligamentous attachments, is displaced.
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A type IIB fracture of the distal clavicle. The conoid ligament is ruptured, while the trapezoid ligament remains attached to the distal segment. The proximal fragment is displaced.
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Anatomy of the clavicle indicating potential fracture sites.
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Nondisplaced middle clavicle fracture.
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Displaced fracture of middle clavicle.
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Displaced middle clavicle fracture.
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Clavicle fracture with rib fractures. Remember to look for associated injuries.