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Clavicle fracture

Last reviewed: 5 Oct 2024
Last updated: 12 Sep 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • pain over clavicle
  • guarding
  • point tenderness over site of fracture
  • soft tissue swelling at site of fracture
  • deformity or step-off at site of fracture
  • crepitus
Full details

Other diagnostic factors

  • ecchymosis at site of fracture
  • wound overlying site of fracture
  • skin tenting
Full details

Risk factors

  • acute trauma to the clavicle
  • male sex
  • age <30 years
  • age ≥65 years in females
  • osteoporosis (pathological fractures)
  • bone tumour (pathological fractures)
  • low BMI (insufficiency fractures)
  • prior fracture (insufficiency fractures)
  • prolonged corticosteroid use (insufficiency fractures)
Full details

Diagnostic investigations

1st investigations to order

  • clavicle x-ray series
  • CT chest, abdomen, pelvis
Full details

Investigations to consider

  • chest x-ray
  • scapula x-ray series
  • shoulder x-ray series
  • CT clavicle
  • ultrasound of clavicle
  • MRI of acromioclavicular or sternoclavicular joint
Full details

Treatment algorithm

INITIAL

involved in high-energy trauma

ACUTE

non-stress fractures

stress fractures

Contributors

Authors

Philip H Cohen​, MD

​Clinical Professor of Medicine

UCLA David Geffen School of Medicine

Los Angeles

CA

Disclosures

PHC has given lectures for MCE Conferences and received a stipend and travel expenses.

Thomas J Kremen, MD

Assistant Professor in Residence

Department of Orthopaedic Surgery

UCLA David Geffen School of Medicine

Los Angeles

CA

Disclosures

TJK is on the editorial board member for American Journal of Sports Medicine.

Fletcher R Preuss, MD

Resident Physician

Department of Orthopaedic Surgery

UCLA David Geffen School of Medicine

Los Angeles

CA

Disclosures

FRP declares that he has no competing interests.

Peer reviewers

James F. Mooney III, MD

Professor

Department of Orthopedic Surgery

Atrium Health Wake Forest Baptist

Winston-Salem

NC

Disclosures

JFM declares that he has no competing interests.

Niel Kang, MBBS, MA (Cantab), FRCS (Tr & Orth)

Consultant Trauma and Orthopaedic Surgeon

Cambridge University Hospitals NHS Trust

Cambridge

UK

Disclosures

NK declares that he has no competing interests.

  • Clavicle fracture images
  • Differentials

    • Clavicle contusion
    • Haematoma
    • Sprain of acromioclavicular joint
    More Differentials
  • Guidelines

    • Clinical practice guideline for the treatment of clavicle fractures
    • ACR Appropriateness Criteria: shoulder pain-traumatic.
    More Guidelines
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