Clavicle fracture (peds): Difference between revisions
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==See Also== | ==See Also== | ||
*[[Fractures and dislocations (peds)]] | |||
== References == | == References == | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
[[Category: Peds]] | [[Category: Peds]] |
Revision as of 06:25, 13 September 2015
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 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
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 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
- Discharge home
- Middle third
- Routine follow up with PMD
- Medial
- Ortho consult
- Distal
- Depends on degree of displacement (routine follow up vs consult)