Clavicle fracture (peds): Difference between revisions

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== Background==
==Background==
*Newborn  
*Newborn  
**Usually result from birth injury
**Usually result from birth injury
*Fracture in <2yo should raise possibility of abuse  
*Fracture in <2yo should raise possibility of abuse  


== Diagnosis==
==Diagnosis==
*Newborn  
*Newborn  
**Upper extremity palsy (brachial plexus injury)  
**Upper extremity palsy (brachial plexus injury)  
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*CXR
*CXR


== Treatment==
==Treatment==
*Neonatal  
*Neonatal  
**No treatment necessary  
**No treatment necessary  
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**Significant displacement: ORIF
**Significant displacement: ORIF


== Disposition==
==Disposition==
*Neonatal  
*Neonatal  
**Discharge home  
**Discharge home  
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*[[Fractures and dislocations (peds)]]
*[[Fractures and dislocations (peds)]]


== References==
==References==
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]

Revision as of 21:26, 6 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" 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

Diagnosis

  • CXR

Treatment

  • 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 PMD
  • Medial
    • Ortho consult
  • Distal
    • Depends on degree of displacement (routine follow up vs consult)

See Also

References