Clavicle fracture (peds): Difference between revisions
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*Fracture in <2 year-old should raise possibility of abuse
*Fracture in <2 year-old should raise possibility of abuse


==Evaluation==
==Clinical Features==
*Newborn  
===Newborn===
**Upper extremity palsy (brachial plexus injury)  
*Upper extremity palsy (brachial plexus injury)  
**"Pseudoparalysis" secondary to pain  
*"Pseudoparalysis" secondary to pain  
**Callous at clavicle during first 2-3wk of life  
*Callous at clavicle during first 2-3wk of life  
*Middle Third fracture  
 
**Most common  
===Middle Third fracture===
*Medial clavicle fracture  
*Most common  
**Rare  
 
**If displaced anterior: tenderness and palpable protrusion of distal end  
===Medial clavicle fracture===
**If displaced posterior: compression of trachea/esophagus possible  
*Rare  
*Distal clavicle fracture  
*If displaced anterior: tenderness and palpable protrusion of distal end  
**Rare  
*If displaced posterior: compression of trachea/esophagus possible  
**Due to direct trauma
 
===Distal clavicle fracture===
*Rare  
*Due to direct trauma


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 05:36, 1 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

Evaluation

  • CXR

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)

See Also

References

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