Clavicle fracture (peds): Difference between revisions
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==Management== | ==Management== | ||
===Neonatal=== | ===Neonatal=== | ||
*No treatment necessary | *No treatment necessary | ||
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**Adequate even for displaced and overlapping fracture | **Adequate even for displaced and overlapping fracture | ||
===Medial=== | ===Medial=== | ||
*Anterior displacement: ORIF | *Anterior displacement: ORIF | ||
*Posterior displacement: emergent reduction by ortho or trauma | *Posterior displacement: emergent reduction by ortho or trauma | ||
===Distal=== | ===Distal=== | ||
*Minimal displacement: [[sling]] | *Minimal displacement: [[sling]] | ||
*Significant displacement: ORIF | *Significant displacement: ORIF | ||
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*Discharge home | *Discharge home | ||
===Middle third=== | ===Middle third=== | ||
*Routine follow up with primary care provider | *Routine follow up with primary care provider | ||
===Medial=== | ===Medial=== | ||
*Ortho consult | *Ortho consult | ||
===Distal=== | ===Distal=== | ||
*Depends on degree of displacement (routine follow up vs consult) | *Depends on degree of displacement (routine follow up vs consult) | ||
Revision as of 19:52, 3 August 2016
This page is for pediatric patients; see clavicle fracture for adult patients
Background
- Newborn
- Usually result from birth injury
- Fracture in <2 year-old should raise possibility of abuse
Clinical Features
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
Management
Neonatal
- No treatment necessary
Middle Third
- Arm sling x 3-4wk
- Adequate even for displaced and overlapping fracture
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)