Clavicle fracture (peds): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
Neil.m.young (talk | contribs) (Text replacement - "Fx" to "fracture") |
||
| Line 9: | Line 9: | ||
**"Pseudoparalysis" 2/2 pain | **"Pseudoparalysis" 2/2 pain | ||
**Callous at clavicle during first 2-3wk of life | **Callous at clavicle during first 2-3wk of life | ||
*Middle Third | *Middle Third fracture | ||
**Most common | **Most common | ||
*Medial clavicle | *Medial clavicle fracture | ||
**Rare | **Rare | ||
**If displaced anterior: tenderness and palpable protrusion of distal end | **If displaced anterior: tenderness and palpable protrusion of distal end | ||
**If displaced posterior: compression of trachea/esophagus possible | **If displaced posterior: compression of trachea/esophagus possible | ||
*Distal clavicle | *Distal clavicle fracture | ||
**Rare | **Rare | ||
**Due to direct trauma | **Due to direct trauma | ||
Revision as of 04:41, 3 July 2016
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 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
Diagnosis
- CXR
Treatment
- 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 PMD
- Medial
- Ortho consult
- Distal
- Depends on degree of displacement (routine follow up vs consult)