CLAVICULA

FRACTURE

Dr. Wondwossen M.
 Introduction
CLAVICLE
• S – shaped, Long & Tubular bone

• Subcutaneous along its length

• Medially – SCJ

• Laterally- ACJ & coracoclavicular ligaments

• Muscle attachment-
• Medial part(quadrangular) …………SCM
• Middle part(tublar)…………provides protection
• Lateral Part(flat)……… Trapezius, pec. Major
• Subclavian vessels & brachial plexus lies posterior
to it

• 1st bone to ossify

 Function

 Power & stability of the

arm

 Motion of the shoulder

girdle

 Protection

 Muscle attachment
 Epidemiology

Clavicle fractures are common

injuries

Account for 5-10% of all

fractures

Common in young male

Easy to diagnose

Majority unite uneventfully

 Mxn. Of Injury
 Direct blow

 Indirect
 Fall against lateral
shoulder
 Fall on outstretched hand

 Birth trauma

 Pathologic #

 Seizures
 Diagnosis
 History
 trauma, falls, tumor, seizure, elderly
 Pain & swelling

 Compare opposite side

 Limitation of motion

 Bruising, tenderness, creptition, deformity

 Arm usually held across the chest with the opposite limb
supporting it

 Look for associated injuries

 Neurovascular
 pneumothorax
 AP x-ray
 Evaluate superior-inferior displacement

 45o cephalic tilt view

 Evaluate AP displacement

 Chest x-ray

 CT- scan
 Classification
 Group I : Middle third
 Most common (80%)

 Group II: Distal third

 10-15%

 Group III: Medial third

 Least common (5%)
 Group- 2 (type-i)

 Fracture lateral to CCL

 Minimally displaced

 CCL are intact

 Stable Fracture

 Rx – Non-Operative
 Group-2(type-IIA)

 Fracture medial to CCL

 CCL are intact

 Unstable medial segment

 Higher non-union rate with non-

operative Rx

 RX- Operative
 Group-2(type-IIB)

 Fracture b/n intact

trapezoid & ruptured
conoid ligaments

 Unstable medial clavicle

 High rate of non-union

 Rx - Operative
Group-3
Treatment
 Complications

 Pneumothorax

 Neurovascular injury

 Non-union

 Mal-union

 Post-Traumatic Arthritis
THANKS