Clavicle fracture
A partial or complete break of the clavicle bone.
A clavicle fracture is a partial or complete break of the collarbone. Symptoms include pain and tenderness at the break site, reduced ability to move the affected arm, a cracking sensation during the injury, swelling, and deformity. Possible complications include pneumothorax (air in the space around the lung), injury to nearby nerves or blood vessels, and an unpleasant appearance. The injury is usually caused by a fall directly onto the shoulder, a direct blow to the bone, or a fall onto an outstretched arm. It can also happen to a newborn during childbirth. Rare causes include muscle contractions from seizures or minimal trauma in people with pathologic bone conditions. The middle third of the clavicle is most commonly fractured. Diagnosis is based on symptoms and the injury history, then confirmed with X-rays.
Treatment can be non-operative or operative. Non-operative care involves immobilizing the arm in a standard sling for three to four weeks, and pain medication like paracetamol (acetaminophen) may help. It can take up to five months for bone strength to return to normal. Surgery, which uses plates and screws or an intramedullary device to align and stabilize the fracture, is considered for open fractures, nerve or blood vessel involvement, skin tenting, or severe displacement in a high-demand individual. Clavicle fractures are most common in people under 25 and those over 70. In the younger group, males are affected more often than females. They account for about 5% of all fractures in adults and about 13% in children.
Signs and symptoms include pain, especially with arm movement or on the front upper chest; swelling; deformity, sometimes with a sharp bone end pressing up under the skin (skin tenting); a fracture that can be felt through the skin after swelling subsides; sharp pain with any movement; referred pain as a dull to extreme ache in and around the clavicle and surrounding muscles; possible nausea, dizziness, or spotty vision from extreme pain; rapid breathing if the lung is affected (pneumothorax); and arm weakness if neurovascular structures are damaged (brachial plexus injury).
The mechanism is usually injury or trauma. Most often, it results from a fall directly onto the shoulder (87%), with less common causes being direct impact to the clavicle (7%) or a fall onto an outstretched hand (6%). The clavicle acts as a strut between the ar
- common_age_groups
- Under 25 and over 70
- gender_ratio_younger
- Males more often affected than females
- fracture_percentage_in_adults
- About 5% of all fractures
- fracture_percentage_in_children
- About 13% of fractures
- most_common_location
- Middle third of clavicle (80% of fractures)
- most_common_cause
- Fall directly onto shoulder (87%)
Lore & Background
Clavicle fractures are usually a result of injury or trauma, with the most common mechanism involving a fall directly onto the shoulder (87%). Less common causes include direct impact to the clavicle (7%) or a fall onto an outstretched hand (6%). Incidents that may lead to a clavicle fracture include automobile accidents, biking accidents, vertical falls on the shoulder joint, or contact sports such as football, rugby, hurling, or wrestling. Newborns may present clavicle fractures following a difficult delivery involving shoulder dystocia. Due to the anatomy of the clavicle, 80% of fractures occur in the middle third of its length, which is its weakest point. When a clavicle fracture occurs, the sternocleidomastoid tends to pull the proximal portion upward while the conoid and trapezoid ligaments, pectoralis minor muscle, and overall weight of the arm pull the distal portion downward, creating the typical 'S' shaped deformity.
Reader's Guide
Clavicle fractures are significant as one of the most common skeletal injuries, particularly in younger and older populations. They represent about 5% of all fractures in adults and 13% in children. The clavicle serves as the only bony attachment between the trunk and the arm, making its integrity crucial for upper limb function. Treatment can be operative or non-operative, with non-operative care involving immobilization in a sling for three to four weeks and pain medication such as paracetamol. Operative treatment uses plates and screws or an intramedullary device. Reasons for surgical repair include open fracture, involvement of nerves or blood vessels, tenting of the skin, or severe displacement in a high-demand individual. It can take up to five months for bone strength to return to normal. Complications can include pneumothorax, injury to nerves or blood vessels, and an unpleasant appearance. The Allman classification system divides fractures into three groups based on location along the clavicle: Group I (middle third, 80%), Group II (distal third, 15%), and Group III (proximal third).
Did You Know?
- Clavicle fractures most commonly occur in people under the age of 25 and those over the age of 70.
- The middle third of the clavicle is involved in 80% of fractures.
- A fall directly onto the shoulder accounts for 87% of clavicle fracture mechanisms.
- Complications can include pneumothorax (air in the pleural space) and injury to nerves or blood vessels.
More in Bone fractures 1-24
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