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Clavicle Fractures

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Edited by Grace Xiong, Brendan Striano, and Harry Lightsey - 7/1/2021

Descriptors

Midshaft vs. distal (in relation to coracoclavicular ligaments)

Exam Pearls

Upper extremity neurovascular exam

Skin threatening: skin tented over bone that is immobile, nonblanchable, or potentially dusky

Workup

Radiographs: Upright clavicle or upright acromioclavicular views (to see bilateral full-length clavicles)

Other imaging: UE CT angiogram if concern for vascular compromise

Labs: only if being admitted for fixation

Other: None

Management

Need for acute intervention: No reduction, immobilization with sling only

Weight-bearing and range of motion: WBAT, ROMAT, out of sling for pendulums

Type of immobilization: Sling for comfort

Admission or discharge status: Discharge with 1-2 week follow up in trauma clinic for repeat XR

Anticoagulation: None

Antibiotics: None

Surgical Indications

Absolute: Open fracture, threatened skin, ipsilateral scapular neck fracture (floating shoulder)

Relative: >100% displaced and >2cm shortening