Clavicle fracture (peds): Difference between revisions
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==Background== | == Background == | ||
*Fx in | |||
*Newborn | *Fx in <2yo should raise possibility of abuse | ||
*Newborn | |||
**Usually result from birth injury | **Usually result from birth injury | ||
==Diagnosis== | == Diagnosis == | ||
*Newborn | |||
**Upper extremity palsy (brachial plexus injury) | *Newborn | ||
**"Pseudoparalysis" 2/2 pain | **Upper extremity palsy (brachial plexus injury) | ||
**Callous at clavicle during first 2-3wk of life | **"Pseudoparalysis" 2/2 pain | ||
*Middle Third Fx | **Callous at clavicle during first 2-3wk of life | ||
**Most common | *Middle Third Fx | ||
*Medial clavicle Fx | **Most common | ||
**Rare | *Medial clavicle Fx | ||
**If displaced anterior: tenderness and palpable protrusion of distal end | **Rare | ||
**If displaced posterior: compression of trachea/esophagus possible | **If displaced anterior: tenderness and palpable protrusion of distal end | ||
*Distal clavicle Fx | **If displaced posterior: compression of trachea/esophagus possible | ||
**Rare | *Distal clavicle Fx | ||
**Rare | |||
**Due to direct trauma | **Due to direct trauma | ||
==Treatment== | == Treatment == | ||
*Neonatal | |||
**No treatment necessary | *Neonatal | ||
*Middle Third | **No treatment necessary | ||
**Arm sling x 3-4wk | *Middle Third | ||
***Adequate even for displaced and overlapping fx | **Arm sling x 3-4wk | ||
*Medial | ***Adequate even for displaced and overlapping fx | ||
**Anterior displacement: ORIF | *Medial | ||
**Posterior displacement: emergent reduction by ortho or trauma | **Anterior displacement: ORIF | ||
*Distal | **Posterior displacement: emergent reduction by ortho or trauma | ||
**Minimal displacement: sling | *Distal | ||
**Minimal displacement: sling | |||
**Significant displacement: ORIF | **Significant displacement: ORIF | ||
==Disposition== | == Disposition == | ||
*Neonatal | |||
**D/c home | *Neonatal | ||
*Middle third | **D/c home | ||
**Routine f/u w/ PMD | *Middle third | ||
*Medial | **Routine f/u w/ PMD | ||
**Ortho consult | *Medial | ||
*Distal | **Ortho consult | ||
*Distal | |||
**Depends on degree of displacement (routine f/u vs consult) | **Depends on degree of displacement (routine f/u vs consult) | ||
==Source== | == Source == | ||
Tintinalli | Tintinalli | ||
[[Category: | [[Category:Ortho]] | ||
[[Category: Peds]] |
Revision as of 22:09, 7 July 2011
Background
- Fx in <2yo should raise possibility of abuse
- Newborn
- Usually result from birth injury
Diagnosis
- Newborn
- Upper extremity palsy (brachial plexus injury)
- "Pseudoparalysis" 2/2 pain
- Callous at clavicle during first 2-3wk of life
- Middle Third Fx
- Most common
- Medial clavicle Fx
- Rare
- If displaced anterior: tenderness and palpable protrusion of distal end
- If displaced posterior: compression of trachea/esophagus possible
- Distal clavicle Fx
- Rare
- Due to direct trauma
Treatment
- Neonatal
- No treatment necessary
- Middle Third
- Arm sling x 3-4wk
- Adequate even for displaced and overlapping fx
- 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
- D/c home
- Middle third
- Routine f/u w/ PMD
- Medial
- Ortho consult
- Distal
- Depends on degree of displacement (routine f/u vs consult)
Source
Tintinalli