This guideline is specific for the assessment and management of clavicle fractures
Three quarters of clavicle fractures are midshaft
The majority of clavicle fractures are managed with analgesia and a broad arm sling
Most clavicle fractures do not require Orthopaedic follow up
Clavicle fractures are common in all ages
The most common site is the mid shaft (three quarters)
Approximately half are greenstick
Epiphyseal (Salter-Harris I and II) fractures are very rare
The most common mechanism of injury is a fall onto the shoulder
In neonates, it may be the result of birth injury – the clavicle is the most common obstetric fracture site
Examine for tenderness and swelling along the line of the clavicle
Infants may present with reluctance to use an arm without a good history of trauma
There is usually a history of a fall onto the shoulder or outstretched arm or a direct blow to the clavicle
Consider Non-Accidental Injury (NAI) in young children if there is an inadequate explanation for the fracture. Complete an Injury Proforma form for children < 2 years (A3 folded sheet located in the Doctor’s offices).
There is usually tenderness or swelling along the clavicle
In the child with multiple injuries, clavicle fractures and upper rib fractures may be associated with injury of the great vessels or brachial plexus. Careful neurovascular examination of the ipsilateral arm should be performed.