Clavicle fracture

Question 1

How are clavicle fractures classified?

Answer 1

Allman classification system

Question 2

What is a Allman classification system type 1?

Answer 2

fracture of the middle third of the clavicle (75%), weakest segment usually stable but significant deformity

Question 3

What is a Allman classification system type 2?

Answer 3

fractures involving the lateral third of the clavicle (20%) when displaced these are usually unstable

Question 4

What is a Allman classification system type 3?

Answer 4

medial third of the clavicle (5%) usually due to multi system poly trauma, can be associated with neuromuscular compromise, pneumothorax or haemothorax due to sitting directly infant of the mediastinum

Question 5

What causes a clavicle fracture?

Answer 5

direct trauma to the clavicle or indirect from a fall onto the shoulder

Question 6

How will fragments in a clavicle fracture usually displace?

Answer 6

medial fragment will displace superiorly due to the sternocleidomastoid muscle pull, the lateral fragment will displace inferiorly due to the weight of the arm

Question 7

What are the clinical features of a clavicle fracture?

Answer 7

sudden onset localised severe pain, made worse on movement of the arm, usually always following trauma, focal tenderness, deformity and mobility at the fracture site, look for open injuries and threatened skin (tented, tethered which and non-blanching) check neuromuscular status of the upper limb due to brachial plexus

Question 8

What is the differential diagnosis of a clavicle fracture?

Answer 8

sternoclavicular dislocation and acromioclavicular joint separation

Question 9

What investigations must be done for a clavicle fracture?

Answer 9

plain film anteroposterior and modified axial radiograph of the affected clavicle allowing displacement to be assessed, may need CT if medial

Question 10

What is the management for a clavicle fracture?

Answer 10

treated conservatively due to no benefit to surgery, so given a sling so that the elbow is supported and deformity is improved, early movement is recommended, if open fracture will need surgery, ORIF is needed if fail to unite

Question 11

What is a major complication of clavicle fracture?

Answer 11

Non- union which is most associated with distal third clavicular fractures , neurovarcular injury, puncture injury

Question 12

What is the healing time fr most clavicular fractures?

Answer 12

4-6 weeks