Clavicle fracture (peds): Difference between revisions
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==Management== | ==Management== | ||
===Neonatal=== | |||
**No treatment necessary | **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== | ==Disposition== | ||
Revision as of 05:37, 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
- 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
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)