Clavicle fracture (peds): Difference between revisions
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== Background == | == Background == | ||
*Newborn | *Newborn | ||
**Usually result from birth injury | **Usually result from birth injury | ||
*Fracture in <2yo should raise possibility of abuse | |||
== Diagnosis == | == Diagnosis == | ||
| Line 22: | Line 21: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Thoracic trauma DDX}} | {{Thoracic trauma DDX}} | ||
==Diagnosis== | |||
*CXR | |||
== Treatment == | == Treatment == | ||
*Neonatal | *Neonatal | ||
**No treatment necessary | **No treatment necessary | ||
| Line 38: | Line 39: | ||
== Disposition == | == Disposition == | ||
*Neonatal | *Neonatal | ||
** | **Discharge home | ||
*Middle third | *Middle third | ||
**Routine | **Routine follow up with PMD | ||
*Medial | *Medial | ||
**Ortho consult | **Ortho consult | ||
*Distal | *Distal | ||
**Depends on degree of displacement (routine | **Depends on degree of displacement (routine follow up vs consult) | ||
== | == References == | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
[[Category: Peds]] | [[Category: Peds]] | ||
Revision as of 06:23, 13 September 2015
Background
- Newborn
- Usually result from birth injury
- Fracture in <2yo should raise possibility of abuse
Diagnosis
- Newborn
- Upper extremity palsy (brachial plexus injury)
- "Pseudoparalysis" 2/2 pain
- Callous at clavicle during first 2-3wk of life
- Middle Third Fx
- Most common
- Medial clavicle Fx
- Rare
- If displaced anterior: tenderness and palpable protrusion of distal end
- If displaced posterior: compression of trachea/esophagus possible
- Distal clavicle Fx
- Rare
- Due to direct trauma
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Diagnosis
- CXR
Treatment
- Neonatal
- No treatment necessary
- Middle Third
- Arm sling x 3-4wk
- Adequate even for displaced and overlapping fx
- Arm sling x 3-4wk
- Medial
- Anterior displacement: ORIF
- Posterior displacement: emergent reduction by ortho or trauma
- Distal
- Minimal displacement: sling
- Significant displacement: ORIF
Disposition
- Neonatal
- Discharge home
- Middle third
- Routine follow up with PMD
- Medial
- Ortho consult
- Distal
- Depends on degree of displacement (routine follow up vs consult)