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Clavicle fractures

Authors
Robert L Hatch, MD, MPH
James R Clugston, MD, MS
Jonathan Taffe, MD
Section Editor
Patrice Eiff, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

Clavicle fractures occur commonly, often as a result of indirect or direct trauma to the shoulder region. Clinicians working in emergency departments and general clinics should be familiar with the common presentations and complications of this injury, as well as basic management.

This topic review will discuss the presentation and management of clavicle fractures. Other shoulder injuries and the approach to undifferentiated shoulder pain are reviewed elsewhere. (See "Acromioclavicular joint injuries ("separated" shoulder)" and "Rotator cuff tendinopathy" and "Evaluation of the patient with shoulder complaints".)

EPIDEMIOLOGY

Clavicle fractures account for approximately 2.6 percent of all fractures [1,2]. The peak incidence occurs in children and young adults. Over one-third of clavicle fractures in males occur between the ages of 13 and 20 years, while 20 percent of clavicle fractures in women occur in the same age group [3]. Incidence falls over subsequent decades before rising again in older men and women.

In a study of 1000 consecutive fractures, 69 percent occurred in the middle third of the bone, 28 percent in the distal third, and 2.8 percent in the proximal third [3]. Distal third fractures are further subdivided into three types [4]. These locations provide the basis for clavicle fracture classification. (See 'Classification' below.)

In older studies, fractures of the proximal clavicle constituted only 2 to 3 percent of all clavicle fractures [1,3]. However, a subsequent study found that 9.3 percent of clavicle fractures involved the medial third [5]. The authors hypothesized that their higher rate was due to the institution's liberal use of CT (22 percent of medial clavicle fractures were seen only on CT).

                              

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Literature review current through: Nov 2016. | This topic last updated: Thu Apr 14 00:00:00 GMT+00:00 2016.
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