Clavicle fracture (peds): Difference between revisions
ClaireLewis (talk | contribs) |
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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*Fracture in <2yo should raise possibility of abuse | *Fracture in <2yo should raise possibility of abuse | ||
== | ==Evaluation== | ||
*Newborn | *Newborn | ||
**Upper extremity palsy (brachial plexus injury) | **Upper extremity palsy (brachial plexus injury) | ||
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{{Thoracic trauma DDX}} | {{Thoracic trauma DDX}} | ||
== | ==Evaluation== | ||
*CXR | *CXR | ||
Revision as of 06:03, 22 July 2016
Background
- Newborn
- Usually result from birth injury
- Fracture in <2yo should raise possibility of abuse
Evaluation
- Newborn
- Upper extremity palsy (brachial plexus injury)
- "Pseudoparalysis" secondary to pain
- Callous at clavicle during first 2-3wk of life
- Middle Third fracture
- Most common
- Medial clavicle fracture
- Rare
- If displaced anterior: tenderness and palpable protrusion of distal end
- If displaced posterior: compression of trachea/esophagus possible
- Distal clavicle fracture
- Rare
- Due to direct trauma
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Evaluation
- CXR
Management
- Neonatal
- No treatment necessary
- Middle Third
- Arm sling x 3-4wk
- Adequate even for displaced and overlapping fracture
- 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 primary care provider
- Medial
- Ortho consult
- Distal
- Depends on degree of displacement (routine follow up vs consult)