Clavicle fracture (peds)

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

Evaluation

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)

See Also

References