Clavicle fracture

What it is

A clavicle fracture is described by which part of the bone is broken. The medial and middle third fractures go together, while the distal type stands on its own, because treatment turns on that division and on whether the fracture is displaced.

The clavicle fractures in the proximal third in 5%, the middle third in 80% and the distal third in 15%, and it is common in children, where it unites rapidly without complications.

Causes and risk

The causes are direct trauma, a FOOSH, and a fall. In the fetus a clavicle fracture is one of the complications of shoulder dystocia, together with brachial plexus injury, humerus fracture and hypoxic brain injury.

The mechanism is a fall on the shoulder in 87%, direct trauma to the clavicle in 7% and FOOSH in 6%.

How it presents

Pain and tenting of the skin are the clinical features, the arm is clasped to the chest to splint the shoulder, and the NVS of the entire upper limb must be evaluated.