Clinical Practice Guidelines : Clavicle fractures

See also:
Clavicle fractures – Fracture clinics

1. 
   Summary
2. 
   How are they classified?
3. 
   How common are they and how do they occur?
4. 
   What do they look like – clinically?
5.  
   What radiological investigations should be ordered?
6. 
   What do they look like on x-ray?
7. 
   When is reduction (non operative and operative) required?
8. 
   Do I need to refer to orthopaedics now?
9. 
   What is the usual ED management for this fracture?
10. 
    What follow-up is required?
11. 
    What advice should I give to parents?
12. 
    What are the potential complications associated with this injury?
13. 
    Parent information fact sheet (PDF)

1. Summary

• Clavicle Fracture is a common injury in children, most often occurring after a simple fall onto an outstretched hand
• These most commonly occur in the middle third of the bone, with the vast majority healing well without intervention beyond sling immobilisation
• Follow-up must be planned for completely off-ended fractures in older children, and for lateral third fractures
• Medial third fractures are uncommon and require careful assessment for associated injuries, especially when displaced.
• All fractures should be assessed using the Advanced Trauma Life Support (ATLS) principles to ensure associated and potentially significant injuries are identified.

2. How are they classified?

Fractures of the clavicle can be classified by its anatomical location (Table 1):

 

Table 1: Classification of clavicle fractures by location.

Location	Frequency	Description
Lateral third	15%	Around and lateral to coracoclavicular ligaments Lateral ⅓ fractures are at higher risk of nonunion than other types
Middle third or midshaft	80%	Defined by shortening/comminution/angulation
Medial third	5%	Bony injury alone Associated sternoclavicular dislocation

3.

How common are they and how do they occur?

The clavicle is one of the most common fractured bones in children.  Half of all paediatric clavicle fractures occur under the age of seven years.  These heal quickly and recover fully. 

Injuries are usually the result of a fall on an outstretched hand with the force transmitted up the arm. 

A direct blow to the outer end of the clavicle (such as a fall onto the point of the shoulder during sporting activities or a striking injury) can be associated with distal third injuries and acromioclavicular joint disruption.

Clavicle fracture is also the most common perinatal fracture associated with birth trauma.

4. What do they look like – clinically?

The vast majority present with pain, swelling and deformity along the line of the clavicle, and a history of a fall onto an outstretched arm. Toddlers may present to ED with only history of avoiding use of the arm, as the trauma may not have been witnessed.

Fractures of the medial third are usually the result of high impact blunt force to the anterior chest (such as in a motor vehicle accident), and can be associated with neurovascular, pulmonary and cardiac (rare) injuries.  Careful airway protection and neurovascular assessment is required.

!Careful neurological examination should be performed to define potential (but rare) associated brachial plexus injury.

Vascular assessment of the arm should also be performed as the subclavian artery runs closely apposed to the clavicle in the middle third. 

5. What radiological investigations should be ordered?

Standard anteroposterior (AP) and AP with 15 degrees cephalic tilt x-ray of the clavicle will show the fracture in two planes and define displacement.

CT Scan is very seldom required.  It may be needed in medial third injuries to assess tracheal impingement and thoracic anatomy, or in displaced lateral third injuries to assess the coraco-clavicular ligament, with orthopaedic consultation.

6. What do they look like on x-ray?

Middle third fracture

Seven year old boy with angulated (not translated) fracture of the middle third of the clavicle.
 

A middle third fracture with greater than 100% displacement



Lateral third

Figure 2:  Undisplaced lateral third fracture of the clavicle in a 12 year old boy.



Sternoclavicular dislocation (posterior displaced)

A

B

Figure 3:  A) 14 year old with posterior dislocation of the medial end of right clavicle.   This is difficult to see on x-ray.  B) The posterior dislocation (red arrow) is more evident on CT scan.

7. When is reduction (non operative and operative) required?

Reduction of middle-third clavicle fractures in ED is almost never required. Angulation is likely to improve with a supportive broad-arm sling, and later remodelling.

Indications for immediate orthopaedic referral are listed in point 8 below

Some older children with completely displaced & shortened fractures ultimately undergo open reduction following outpatient review, as in point 10 below.

8. Do I need to refer to orthopaedics now?

The majority of clavicle fractures are easily managed with a sling and analgesia.

Indications for immediate consultation include:

• Open fractures
• Displaced medial third fractures
• Neurovascular injury with fracture
• Skin integrity at risk over fracture
• Displaced lateral third fractures
• Pathological fractures

Orthopaedic consultation should also occur for middle third fractures in older children where there is

• Severe comminution or
• Complete displacement (off-ending), &/or
• Shortening >2cm

9.

What is the usual ED management for this fracture?

Fracture type	Type of reduction	Immobilisation method & duration
Middle third	Generally no reduction required	Broad arm sling to support limb for 2-3 weeks or until comfortable Regular analgesia as required
Lateral third	If undisplaced, no reduction required If displaced, refer to the nearest orthopaedic service on call	Broad arm sling to support limb for 4 weeks or until comfortable Regular analgesia as required
Medial third	If undisplaced, no reduction required If displaced, immediate referral to the nearest orthopaedic service on call	Broad arm sling to support limb

10.

What follow-up is required?

Middle third fracture

Children
<11 years old with undisplaced fractures do not usually require follow-up by a GP or fracture clinic.  Repeat x-rays are usually not required, as the remodelling capacity in this age group is very high.  Mobilisation out of the sling commences at two weeks depending on pain control, with contact sports delayed until 6 weeks.

GP review of at 1-2 weeks post injury will consist of familiarisation with the history and radiographs and assessment of pain and function.  Any persistent pain/tenderness at the fracture site not improving at 2-4 weeks may be an early indicator of non-union, and should prompt repeat X-rays and orthopaedic referral.


All children >14 years with completely displaced fractures (i.e. off-ended) should be referred to an orthopaedic fracture clinic with repeat radiograph, as this cohort is at the highest risk for non-union.

Other children ≥11 years old, or displaced fractures
<11 years old, can be followed up with the family GP in approximately one week.  Persistent pain not improving at the fracture site at 2-3 weeks, with ongoing disability may be an early indicator for non-union, and should prompt repeat xrays and orthopaedic referral.

Lateral third fracture and medial fractures/dislocations

Follow up in orthopaedic fracture clinic

Neonatal clavicle fractures

Simple Swathe as shown for 2 weeks

11. What advice should I give to parents?

The majority of uncomplicated middle third fractures will have excellent functional and cosmetic outcomes.

Provide parent with
fracture of the clavicle (collarbone) fact sheet.

Pain from the fracture and restriction of movement are usual for 2-3 weeks and will require regular analgesia.

The child should re-attend if pain is increasing.   Contact sports and activities should be avoided for approximately six weeks post removal of sling.  A lump usually develops at the fracture site, which may be visible and palpable for at least one year and then resolves.

12. What are the potential complications associated with this injury?

• Neurovascular complications are rare
• Nonunion is uncommon, but is more likely in the older adolescent or in lateral third fractures
• Malunion – palpable or visual lump, which diminishes with remodelling
• Degenerative arthritis if acromioclavicular joint intra-articular incongruence

See
fracture clinics for other potential complications.

References (ED setting)

Asadollahi, S. and Saremi, S. Surgical management of displaced midshaft clavicle fracture in the skeletally immature patient – What is the Hunter JB. Fractures around the shoulder and humerus. In Children’s Orthopaedics and Fractures,3rd Ed. Benson M, Fixsen J, Macnicol M, Parsch K (Eds). Springer, London 2010. p.717-30.

Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev 2009; CD007121.

Mehlman C. et al. Operative treatment of completely displaced clavicle shaft fractures in children, J Pediatr Orthop 2009; 29(8):851-5

Klein SM, Badman BL, Keating CJ, Devinney DS, Frankle MA, Mighell MA. Results of surgical treatment for unstable distal clavicular fractures. J Shoulder Elbow Surg 2010; 19: 1049-55.

Pecci M. & Kreher, J. Clavicle Fractures Am Fam Physician. 2008 Jan 1;77(1):65-70.

Simon RR, Sherman SC, Koenigsknecht SJ. Clavicle fractures. In Emergency Orthopaedics – The Extremities. 5th Ed. McGraw-Hill, Chicago 2007. P.285-7.

Vargas-Vila, M et al. The Community Orthopaedic Surgeon Taking Trauma Call: Pediatric Midshaft Clavicle Fracture Pearls and Pitfalls, J Orthop Trauma 2019;33:S1-S5

Young SJ, Barnett PL, Oakley EA. Fractures and minor head injuries: Minor injuries in children II. Med J Aust 2005; 182: 644-8.

Broken Collarbone (Clavicle) | Michigan Medicine

Topic Overview

What is the collarbone?

The collarbone (clavicle) is one of the main bones of the shoulder joint. It holds the shoulder up and, along with the shoulder blade (scapula) and acromioclavicular (AC) joint, provides stability and strength to the shoulder. The collarbone also protects nerves and blood vessels from the neck to the shoulder.

What causes a broken collarbone?

A broken collarbone is usually caused by direct contact to the collarbone or to the outside of the shoulder. This often occurs when playing sports such as football, wrestling, or ice hockey.

The collarbone is one of the most commonly broken (fractured) bones. Young men ages 13 to 20 break it most often. Younger children have greater chances of a broken collarbone during play.

What are the symptoms?

Symptoms of a broken collarbone include:

• Immediate pain after falling or being hit on the collarbone or in the shoulder area.
• Inability to raise the affected arm because of pain.
• A grinding feeling when trying to lift the affected arm.

The affected shoulder does not always appear out of position. But if a deformity is present, it appears as a bump or swelling along the collarbone or at the AC joint. The bone rarely breaks through the skin. But it may push the skin out, causing it to have a tent-shaped look.

A broken collarbone usually is not a serious injury. In rare cases, a broken collarbone can injure a lung or rib or pinch nerves or blood vessels. This may cause the arm to turn pale, tingle, and feel cool or numb.

How is a broken collarbone diagnosed?

Your doctor can usually diagnose a broken collarbone by asking you questions and examining you. Your doctor will check:

• The affected area and look for a lump or bump.
• Blood flow, by taking your pulse and checking your skin color and temperature.
• For damage to your nerves and blood vessels.
• How well you can move your shoulder and other joints.
• The muscle strength of your shoulder.

Your doctor will usually do an X-ray to pinpoint the location and severity of the break.

How is it treated?

Many broken collarbones heal on their own. If you don’t need surgery, you will use a sling to keep your arm and shoulder from moving while the bone heals. You will probably use the sling for at least 3 to 4 weeks. Sometimes a figure-8 strap is used instead of a sling.

You can begin simple exercises immediately and move on to strengthening exercises when they don’t cause pain. Ask your doctor when it is safe to begin to exercise. If you start too soon, the broken collarbone may not heal well. If you are active, do not play sports or other activities until you can move your shoulder easily and it feels strong.

To help relieve pain, try acetaminophen or a nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen. Be safe with medicines. Read and follow all instructions on the label.

Surgery may be recommended for severe breaks. When the ends of the broken bone do not line up with each other (displaced), surgery is more likely. Many experts believe surgery is especially important in young, active people.

After surgery, you will use a sling for up to 6 weeks. Your doctor or physical therapist will teach you gentle exercises to keep your shoulder moving for about 6 weeks, until you can start exercises to get your strength back. Most people have returned to all their activities by 3 months after surgery.^{footnote 1}

Missed clavicular fracture; inadequate radiograph or occult fracture?

Fractures of the clavicle are extremely common accounting for 5%–10% of all fractures.¹ It is well recognised that the initial radiograph may be negative in children and such children often present at a later date with a complaint of a palpable lump in the region of the clavicle. This has led to the practice of treating all clinically fractured clavicles with a normal radiograph as a fracture.² A search of the English literature and standard orthopaedic text failed to find such a recommendation for adults. We present a case series of three adults who had a normal initial radiograph of the clavicle after trauma and who subsequently had a fracture verified at re-presentation.

CASES

Over a two year period the authors were involved in the management of three adult patients who were suspected of fractured clavicle on clinical grounds but whose initial anterior-posterior (A-P) radiographs were normal. The patients re-presented within two weeks with persistent symptoms and repeat radiographs showed fractured clavicle. All three patients had a fracture of the mid-shaft of the clavicle (see table 1 and fig 1).

Table 1

 Patient characteristics

Figure 1

 Initial radiograph with no fracture visible (A) and the same radiograph a week later showing a fracture (B).

DISCUSSION

Occult fracture is well described in the hip and the scaphoid and failure to recognise this could lead to serious consequences. While clavicular fracture is often viewed as benign, it is important for patients to be aware if they have a fracture as it has implications on expected time of recovery and when they can return to work. In addition complications such as non-union do occur and inadequate initial immobilisation is a common cause.^3,4 Two views of the clavicle, A-P and 45° cephalic tilt were advocated by Widner⁵ however, it is the standard practice in most radiology departments to produce a single A-P view. In addition the standard exposure for the shaft of clavicle over exposes the lateral third of the clavicle while the medial third is often obscured by overlapping ribs, vertebral, and mediastinal shadows. All our patients had a single A-P view radiograph. It is possible that these fractures would not have been missed had a 45° cephalic tilt view been obtained. Clinicians should be aware that some clavicular fractures will be occult in the standard A-P view. We therefore recommend that if there is a strong clinical suspicion of a fracture of the clavicle further views should be obtained. If radiographs remained negative the patient should be treated as though there was a fracture and this possibility must be communicated to the patient. Patients with a strong clinical suspicion of a fracture should be asked to re-attend in about 10 days, if symptoms persist, for a repeat radiograph as is commonly practised for fractured scaphoid.

REFERENCES

1. ↵

   Simpson NS, Jupiter JP. Clavicle non-union and malunion: evaluation and surgical management. J Am Acad Orthop Surg1993;4:1–8.

2. ↵

   Rockwood and Green’s fractures in adults. 3rd ed. Philadelphia: J B Lippincott, 1991:949.

3. ↵

   Yates DW. Complications of fractures of the clavicle. Injury1976;7:189–93.

4. ↵

   Jones GL, McCluskey GM 3rd, Curd DT. on-union of the fractured clavicle: evaluation, aetiology, and treatment. J South Orthop Assoc2000;9:43–54.

5. ↵

   Widner LA, Riddewood HO. The value of the lordotic view in diagnosis of fractured clavicle. Int Radiol1980;5:69–70.

Orthopedic Shoulder & Elbow Surgeon

How common are clavicle or “collar bone” fractures?

Clavicle fractures, also known as “collar bone” fracture, are fairly common and can account for up to 5% of all fractured bones in adults. 

 

How do clavicle fractures occur?

Clavicle fractures often occur from a direct blow to the shoulder from a fall or sometimes from more serious trauma like a motor vehicle crash.

 

How is a clavicle fracture diagnosed?

A physical examination can confirm the diagnosis of a broken clavicle.  There is often very clear pain and swelling overlying the clavicle at the site of the fracture.  An x-ray of the clavicle will confirm the diagnosis of a clavicle fracture.

 

Why is the clavicle important?

The clavicle is an important strut for support and motion of the shoulder.   Many think of the clavicle as a simple and straight bone, but it is actually quite complex and critical for shoulder function.  The clavicle is actually s-shaped and serves as a crankshaft for the shoulder.  The clavicle serves a key role as a mobile strut for scapular (shoulder blade) and arm motion.

 

How are clavicle fractures treated?

Most clavicle fractures are able to be successfully treated non-surgically with a sling and rehabilitation; however, some displaced and more complex clavicle fractures are often treated with surgery.

 

When do clavicle fractures need surgery?

Clavicle fractures that are displaced or shifted significantly may require surgery.  Additionally, clavicle fractures with interposed loose “butterfly” fragments or a “kickstand” piece may require surgery.  The physical examination can reveal significant clavicle shortening or a “scapular droop,” which provides important clinical information.  A shoulder specialist can perform a clinical examination and x-ray to see whether surgical or non-surgical treatment will be the best.

 

Read more about shoulder fractures here: http://www.brentmorrismd.com/services/shoulder-fracture

 

About Us:

Dr. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist inin Lexington, Kentucky at Baptist Health Lexington – Orthopedics and Sports Medicine.  Dr. Morris has expertise in treating shoulder fractures and is very experienced in treating clavicle fractures.   Dr. Morris is an Fellow of the American Academy of Orthopedic Surgeons (FAAOS) and an Active Member of American Shoulder and Elbow Surgeons (ASES).  Dr. Morris and his research team have published extensively on shoulder surgery and ways to improve outcomes and patient satisfaction following shoulder surgery.  He is co-author of a textbook devoted to shoulder surgery.  For more information about Dr. Morris, visit online at www.brentmorrismd.com.

 

Brent J. Morris, MD

Board-Certified Orthopedic Surgeon

Orthopedic Shoulder and Elbow Surgeon

Shoulder Replacement and Revision Shoulder Replacement Specialist

Baptist Health Lexington – Orthopedics and Sports Medicine

Fellow American Academy of Orthopaedic Surgeons (FAAOS)

Active Member American Shoulder and Elbow Surgeons (ASES)

Author

Dr. Brent J. Morris

Clavicle Fracture – Undergraduate Diagnostic Imaging Fundamentals

Clinical:

History – This 32 year old male was checked into the boards during a hockey game.  He had immediate pain in his left shoulder.

Symptoms – The patient had severe pain in his left shoulder region.  It was difficult for him to move his arm due to pain. Range of motion of the gleno-humeral joint was mildly limited due to pain.

Physical – There was soft tissue swelling over the lateral clavicle and there was a hard protuberance in this region as well.

DDx:

Hematoma

Acromio-Clavicular joint dislocation

Clavicle fracture

Imaging Recommendation

ACR – MSK – Acute Shoulder Pain, Variant 1

Shoulder X-rays

ODIN Link for Clavicle Fracture images, Figure 14.1A and B: https://mistr.usask. ca/odin/?caseID=20161219111639935

Figure 14.1A X-ray of the left shoulder, pre-operative, clavicle fracture.

 

Figure 14.1B X-ray of the left shoulder, post-operative, clavicle fracture.

Imaging Assessment

Findings:

There was a comminuted, impacted, fracture of the left clavicle at the junction of the middle 1/3 and the lateral 1/3.  The angle formed at the fracture site was mild to moderate and directed cranially. The angle created at the fracture site is due to the attachment of the sternocleidomastoid muscle pulling the medial fragment in a cranial direction.

Interpretation:

Impacted, comminuted, left clavicle fracture.

Diagnosis:

Clavicle fracture

Discussion:

Radiography is a useful initial screening modality for acute shoulder pain of all causes. Radiography is useful in the evaluation of fractures of the shoulder girdle. All radiographic shoulder studies should include frontal examinations. The frontal views can be straight antero-posterior projection (AP) with the humerus in neutral position or with the humerus in internal and/or without external rotation. Local protocols for radiographic evaluation of the shoulder for trauma vary widely. However, the shoulder trauma protocol should have at least three views, of which two views are orthogonal.

X-ray findings may include:

• The most common location for a clavicular fracture is at the junction of the lateral 1/3 and the middle 1/3.
• In children there may be an incomplete or greenstick type of fracture.
• Clavicle fractures may occur in the newborn with difficult deliveries.
• The medial clavicular fragment is typically cranially displaced due the pull of the sternocleidomastoid muscle.
• In most circumstances there is either a fracture of the clavicle or an acromio-clavicular joint dislocation and the two injuries are usually mutually exclusive.

---

Figure 14. 1A X-ray of the left shoulder, pre-operative, clavicle fracture by Dr. Brent Burbridge MD, FRCPC, University Medical Imaging Consultants, College of Medicine, University of Saskatchewan is used under a CC-BY-NC-SA 4.0 license.

Figure 14.1B X-ray of the left shoulder, post-operative, clavicle fracture by Dr. Brent Burbridge MD, FRCPC, University Medical Imaging Consultants, College of Medicine, University of Saskatchewan is used under a CC-BY-NC-SA 4.0 license.

Broken Collarbone – Emory Healthcare

Broken Collarbone / Clavicle Fracture

The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The clavicle is a long bone and most breaks occur in the middle of it. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade.

Clavicle fractures are often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In babies, these fractures can occur during the passage through the birth canal.

Broken Collarbone/Clavicle Fracture Symptoms

• Clavicle fractures can be very painful and may make it hard to move your arm.
• Sagging shoulder (down and forward)
• Inability to lift the arm because of pain
• A grinding sensation if an attempt is made to raise the arm
• A deformity or “bump” over the break
• Bruising, swelling, and/or tenderness over the collarbone

There is usually an obvious deformity, or “bump,” at the fracture site. Gentle pressure over the break will bring about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a “tent” formation. In order to pinpoint the location and severity of the break, your doctor will order an x-ray. X-rays of the entire shoulder will often be done to check for additional injuries.

If the broken ends of the bones have not shifted out of place and line up correctly, you may not need surgery. Broken collarbones can heal without surgery.

Non-Surgical Broken Collarbone Treatment Options

Non-surgical treatment options for a broken collarbone include:

• Sling
• Medication
• Physical Therapy

Surgical Treatment for Broken Collarbone

If your bones are out of place (displaced), your doctor may recommend surgery. Surgery can align the bones exactly and hold them in good position while they heal. This can improve shoulder strength when you have recovered. The orthopaedic surgeon may use plates and screws or pins to hold the fracture in place after the bones are realigned.

ORIF Procedure Detroit | Clavicle Fractures Treatment Royal Oak

What is a Clavicle Fracture?

A clavicle fracture refers to a broken collarbone and is a common injury associated with contact sports such as football and martial arts, as well as impact sports such as motor racing. A direct blow over the shoulder, a fall on an outstretched arm, or a motor vehicle accident may also cause the clavicle bone to break. Most clavicle fractures occur in the shaft or middle portion of the bone. Clavicle fractures are quite common and occur in individuals of all ages.

What does ORIF mean?

ORIF/open reduction and internal fixation is a surgical procedure employed for the treatment of a clavicle fracture not amenable to non-surgical conservative treatment.

Normal Anatomy

The collar bone or clavicle is a bone situated horizontally, connecting the sternum (breastbone) to the humerus or bone of the upper arm, on either side of the body.

Signs and Symptoms of Clavicle Fractures

Signs and symptoms of a clavicle fracture may include:

• Swelling, tenderness, and/or bruising over the break
• Inability to lift the arm because of pain
• A bump or deformity over the break
• A sensation of grinding when you try to lift the arm
• Sagging of the shoulder forward and downward

Diagnosis of Clavicle Fractures

The diagnosis of a clavicle fracture comprises of a physical examination, X-ray imaging, and CT scan. Physical examination determines the site and location of the fracture. X-ray and CT scan help evaluate the type and severity of the fracture and the presence of any other associated injuries.

Preparation for Surgery

Since ORIF is usually performed to treat a severe fracture, it often takes place as an emergency procedure following the injury. Prior to surgery, you may have the following:

• Physical exam to examine blood circulation and nerves affected by the fracture
• X-ray, CT scan, or MRI scan to assess surrounding structures and broken bones
• Blood tests
• Depending on the type of fracture you have sustained, you may be given a tetanus shot if you are not up to date with your immunizations
• A discussion with an anesthesiologist to determine the type of anesthesia you may undergo
• A discussion with your doctor about the medications and supplements you are taking and the need to stop any of these 

Treatment for Clavicle Fractures 

The management of a clavicle fracture is comprised of non-surgical and surgical methods. The choice of treatment depends on the type and location of the fracture.

Non-surgical Treatment

The nonsurgical approach involves placing your arm in a sling to immobilize the bones and allow healing, medications, and supplements to promote healing and relieve pain, and physical therapy to prevent stiffness and weakness of the shoulder, restore range of motion, and strengthen muscles.

Surgical Treatment

Open reduction and internal fixation is the procedure most commonly used to treat clavicle fractures.

The surgery is performed under sterile conditions in the operating room under general anesthesia.

• After sterilizing the affected area, your surgeon will make small incisions around the clavicle muscles. 
• Your surgeon will locate the fracture by carefully sliding in between the muscles of the clavicle. This technique allows your surgeon to see the fracture without cutting directly through the muscles.  
• Special instruments are used to reposition (reduce) the bone fragments into their normal alignment. 
• Bone fragments are then held in place with special metal hardware such as metal wires, plates, pins, or screws. 
• After securing the bone, the incisions are closed by sutures or tape and sterile dressings applied.

Postoperative Care

You will experience some pain post procedure and pain medication will be prescribed to keep you comfortable. You will need to keep your arm immobile for several weeks by wearing a sling to allow the bone to heal. Your doctor will provide instructions on care of the incision along with applying ice packs to relieve discomfort.

Physical therapy and exercise regimen is suggested to prevent shoulder stiffness, strengthen muscles, and restore range of motion. You will also be advised on diet and supplements high in vitamin D and calcium to promote bone healing. Depending on your health condition and the extent of the injury, you may be able to go home the same day.

Risks and Complications

As with any surgery, some of the potential complications of an ORIF procedure may include:

• Bleeding
• Infection
• Pain
• Anesthetic reactions
• Blood clots or deep venous thrombosis
• Damage to nerves and blood vessels
• Shoulder stiffness
• Hardware irritation
• Failure in bone healing

---

Other Procedures

X-ray of the clavicle with a fracture and normal

No one is immune from injuries, fractures, dislocations and bruises always occur. It is impossible to insure yourself against all possible dangers, but you can find out what they look like. It is enough to make an X-ray with a fracture of the clavicle to determine the degree of danger to the whole body.

Human skeleton and location of the clavicle

Contents of the article:

Clavicle and its functions

The clavicle is a paired bone that has a slight resemblance to the letter S, located above the first rib. It functions as a supporting function of the shoulder girdle, connects the scapula and chest, strengthens the skeleton, and protects important vital organs. This bone is present not only in humans, but also in all four-legged animals that use aprons with their limbs for grasping.

Healthy clavicle

Fracture of the clavicle

This injury is one of the most common fractures among physicians, while in men it is twice as common as among women. The reason is simple, the bone is thin enough and is in a vulnerable spot.The collarbone largely absorbs all blows and the load on the hands, from which it is also often injured.

The fracture is very painful, moreover, dangerous. Fragments of bone can damage blood vessels, nerves, arteries nearby. A fractured collarbone can completely immobilize a person, cause severe bleeding and even be fatal.

Fracture of the clavicle

Definition of clavicle fracture

As mentioned, the clavicle is located next to a large number of nerve nodes and bloodstreams, so it is impossible not to notice the fracture. True, many people may not understand that it is the bones that are injured, referring to a hematoma, muscle pain or injury. Without a clearly protruding bone, it is impossible to determine a fracture without an X-ray. It is worth remembering that this injury is very dangerous and needs urgent medical attention.

X-ray of clavicle fracture, sick or healthy

The first thing to do if you are injured is to see a doctor. The main mistake is the theory that “it will pass by itself.” Incorrectly fused bones are prone to repeated fractures, pain during movement, inflammation with further complications.A visit to a traumatologist is not such a heavy burden.

X-ray fracture of the clavicle

The doctor will examine, listen and send for an x-ray. Only after taking a picture you can understand what you have to deal with. A bruise, crack, dislocation or fracture is possible. In addition, fractures can be with varying degrees of threat to human health and life.

X-rays will allow you to see the condition of the bone and give an accurate diagnosis. The broken collarbone in the picture is visible even to a layman. The radiologist will tell you the result or give it to the traumatologist for further treatment.

Clavicle X-ray should be taken

This type of X-ray is done not only by doctor’s prescription, but also on their own initiative. As an example, athletes who are constantly exposed to stress. The collarbone is a bone that is fragile enough that a precaution will never be superfluous.

Types of clavicle fractures

Clavicle X-ray is prescribed if:

• there are sharp and aching pains in the clavicular region;
• impaired vascular patency for unexplained reasons;
• there are sharp pains when moving the arm;
• neoplasms or tumors appeared in the clavicular region;
• clearly noticeable, visually or by touch, deformation of the bone;
• there are suspicions of mother-in-law, fracture, dislocation or subluxation;
• it is necessary to determine the causal relationship of osteochondrosis or diseases of the vertebral-cervical spine;
• there are suspicions of osteomyelitis;
• suspicions of other diseases.

Only by making an X-ray of the clavicle can you be sure that the bone is healthy. A competent specialist, a radiologist, can easily make a diagnosis based on a picture and refer you to the right specialist.

It is recommended to do an X-ray of the clavicle not only as prescribed by a doctor, but also in case of severe stress on the bone. This is especially worth paying attention to athletes involved in wrestling, shot put or standing barbell lifting.

You can partially insure yourself, observing safety measures, using foods and vitamins rich in calcium.

X-ray diagnostics | Rebirth XXI

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20×40) 9000

500.00

700.00

250. 00

1200. 00

No. 50

No. 60

X-ray
No. 1	Ascending pyelography	800.00
No. 2	Infusion urography (3- 5) without contrast	1500. 00
No. 3	Knee joint functional tests	800.00
No. 4	Metrosalpingography (2 images)	1500.00
No. 5	Metrosalpingoscopy (2 images) 9003	700.00	700.00 No. 6	Plain urography	800.00
No. 7	Lumbar spine functional tests	1500.00
No. 8	X-ray of the thigh in 2 projections	700.00
No. 9	X-ray of the thigh in frontal projection	600.00
No. 10	Radiography of the temporal bones according to Schuller, Mayer, Stenvers	2000.00
No. 11	Radiography of the lower leg in 2 projections	700.00
No. 12	X-ray of the lower leg in frontal projection	600.00
No. 13	X-ray of the sternum	700.00	83
Radiography of the sternum in 2 projections	800.00
No. 15	Radiography of the thoracic spine in 2 projections	1200.00
No. 16	Radiography of the thoracic spine in lateral projection	1000.00
No. 17	Radiography of the thoracolumbar spine in frontal projection (	1200.00
No. 18	Tooth X-ray (control image)	150.00
No. 19	Teeth X-ray	200.00
No. 20	Clavicle X-ray (24×30)	600.00	83
X-ray of the coccyx in 2 projections	1000. 00
No. 22	X-ray of the coccyx in the lateral projection	800.00
No. 23	X-ray of the sacroiliac joint (24×30)	400.00
No. 24	X-ray of large joints in 2 projections 86
No. 25	Radiography of large joints in one projection	400.00
No. 26	Radiography of small joints in 2 projections (18×24)	400.00
No. 27	Radiography of the lower jaw in 2 projections	800. 00
No. 28	X-ray of the lower jaw in 3 projections	900.00
No. 29	X-ray of the lower jaw in the lateral projection
No. 30	X-ray of OGK in 2 projections	550.00
No. 31	X-ray of OGK in 3 projections	600.00
No. 32	Radiography of OGK in direct projection (35×35)	450.00
No. 33	Radiography of OGK in direct projection (children) (24×30)
No. 34	Radiography of the OGK in direct projection (children) (35×35)	300.00
No. 35	X-ray of the shoulder in 2 projections	650.00
No. 36	X-ray of the shoulder in frontal projection	600.00
No. 37	X-ray of the shoulder joint in 2 projections 70083	…00
No. 38	Radiography of the shoulder joint in frontal projection	500.00
No. 39	X-ray of the lumbosacral spine in 2 projections
No. 40	Radiography of the lumbosacral spine in the lateral projection	1000.00
No. 41	Radiography of the paranasal sinuses in 2 projections	500.00
No. 42	Radiography of the paranasal sinuses in frontal projection	500.00
No. 43	Radiography of ribs (30×40)	600.00
No. 44	X-ray of feet with load	1500.00
No. 45	Radiography of the pelvis and hip joints (30×40)	800. 00
No. 46	Radiography of the pelvis and hip joints, 24303	300.00
No. 47	Radiography of the pelvis and hip joints in 2 projections	1000.00
No. 48	Skull X-ray	600.00
No. 49	Skull X-ray in 2 projections	700.00
X-ray of the skull in 3 projections	750.00
No. 51	X-ray of the cervical spine in 2 projections	900.00
No. 52	Radiography of the cervical spine in lateral projection	800.00
No. 53	Tomography using 24×30 film (1 – 3 images)	600.00
No. 54	Tomography using 35×35 film (1 – 3 images)	700.00
No. 55	Tomography using 18×24 film (4 or more images)	600.00
No. 56	Tomography using 24×30 film (4 or more images)	650.00
No. 57	Tomography using 35×35 film (4 or more images)	800.00
No. 58	Urethrography (2cn)	800.00
No. 59	Cystography (2cn)	800.00
Cervical spine functional tests	1200.00
No. 61	Cervical spine through the mouth	900.00

Peculiarities of clavicle fracture treatment

Our life is unpredictable. For example, today we have the opportunity to buy brand new Jaeger LeCoultre further. Tomorrow – we are thinking where to find a part-time job. However, everything that happens is not accidental. As we go through difficulties, we become stronger. Quite often, with an unsuccessful fall, people break their collarbone. And this is a very painful injury that requires special treatment and recovery, which entails significant costs.

Types of clavicle fractures and their treatment

The clavicle is a part of the skeleton that connects the arm to the trunk. The fracture results from a fall on an arm or shoulder. People of all ages can get this injury, from a baby to an elderly person. And funds for treatment are not always enough. You can borrow them from your relatives, get a loan from a bank or hand over to a pawnshop an elite Jaquet Droz watch purchased long ago by following the link. The main thing is to look for a solution to the problem and not give up.

Fractures of the clavicle are closed and open, without displacement and with displacement. Open fractures are quite rare. They often occur as a result of a blow directly to the collarbone, for example, when falling from a great height, during an accident and in other similar situations. The clavicle is conventionally divided into 3 parts: outer, middle and inner. The middle part is the most vulnerable, since it is the thinnest. Quite often, an operation is necessary, which is performed in the case of an open or multi-splintered fracture, which threatens to damage the nerve endings or blood vessels.

With the help of surgical intervention, bone fragments are exposed, reduction and fixation of bone fragments is performed. This can be done using a metal pin, plates, bone homografts and other structures that are chosen by the doctor depending on the severity and nature of the fracture. To avoid displacement, they are attached to the collarbone with special screws, and immobilization is performed with a plaster cast. In this case, it cannot be removed for 4-6 weeks, depending on the complexity of the fracture.At the end of this period, the bandage is removed by a specialist, after which an X-ray is taken.

Once the cast has been removed, a rehabilitation period is required, which depends on the severity of the injury. After normal bone fusion, the function of the shoulder joint is gradually restored. Exercises to strengthen the muscles should be started when the pain sensations decrease significantly. Due to a fracture of the clavicle, a person’s ability to work is lost for about 6-8 weeks.

Dovizioso broke his collarbone in motocross (updated)

Added

• Ducati confirmed the accident and fracture.According to the official statement, “despite not being strictly necessary, the Ducati rider, in consultation with Prof. Porsellini decided to undergo surgery tonight in Modena in order to speed up the healing of his shoulder and get in shape for the first race of 2020. ”
• X-rays at Forlì Hospital confirmed a fracture of the left collarbone. Andrea will be transferred to Modena Hospital. An operation is scheduled there tonight (June 28).

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The Andrea Dovizioso motocross trip on June 28, with the permission of Ducati, ended in disrepair.According to preliminary information, in the race at the Monte Coralli track in Faenza – this was the first stage of the local championship in Emilia-Romagna – he had a severe accident, and probably broke his left collarbone during a fall.

The 34-year-old Italian was taken to the hospital in his hometown of Forlì for examination. According to Sky Sport Italia, this incident was not easy. Dovie hit the ground very hard, so the suspicion of a broken collarbone is well founded. What exactly is with the bone will be visible on x-rays.

Dovizioso is a huge motocross fan and wanted to warm up ahead of the resumption of the MotoGP season on July 19 in Jerez. He started clay training almost as soon as Italy relaxed the anti-virus quarantine in early May and allowed the tracks to be opened.

Alas, this happens even with professionals, not to mention the rest. For example, today the Latvian Pauls Jonas, the MXGP World Championship racer, was injured in a motocross accident. He paid a high price – 3 broken ribs, 5 broken spinous processes of the cervical vertebrae.As for Dovizioso, the pilot is at risk, because there are 22 days before the start of MotoGP, and he is in the hospital. On the nose and a mandatory recovery period.

MotoGP Vice-Champion – the owner of a unique statistical fact. Having made his debut race in the Grand Prix on a crazy map (Italian GP 2001 in GP125) at the age of 15, Dovizioso has not missed a single one since then. The innate caution and control of the motorcycle helped him not get any significant injury for 19 years, and skate 313 world championship races in a row without exception! You might have to wait with 314.

On the other hand, a collarbone fracture is not the worst injury. By installing a titanium plate to fix the fracture site, you can quickly return to the motorcycle. For example, like Jorge Lorenzo at the Netherlands GP: after an accident in a rain training session on Thursday, the Spaniard flew to Barcelona for an operation, came back, and on Saturday already lined up on the grid.