Clavicle fracture (peds) - Revision history

Danbot: Remove refs with incorrect PMIDs (verified against PubMed)

2026-03-22T10:25:20Z

Remove refs with incorrect PMIDs (verified against PubMed)

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	''This page is for pediatric patients; see [[clavicle fracture]] for adult patients''		''This page is for pediatric patients; see [[clavicle fracture]] for adult patients''
	==Background==		==Background==
	*Newborn ~~<ref>Carry PM, et al. Epidemiology and injury type of pediatric clavicle fractures. J Pediatr Orthop. 2022;42(7):e698-e704. PMID 35617013</ref>~~		*Newborn
	**Usually result from birth injury (0.5% normal deliveries; 1.6% breech deliveries)		**Usually result from birth injury (0.5% normal deliveries; 1.6% breech deliveries)
	*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]		*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]

2026-03-22T10:17:24Z

Add peer-reviewed reference

← Revisión anterior		Revisión del 10:17 22 mar 2026
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	''This page is for pediatric patients; see [[clavicle fracture]] for adult patients''		''This page is for pediatric patients; see [[clavicle fracture]] for adult patients''
	==Background==		==Background==
	*Newborn		*Newborn <ref>Carry PM, et al. Epidemiology and injury type of pediatric clavicle fractures. J Pediatr Orthop. 2022;42(7):e698-e704. PMID 35617013</ref>
	**Usually result from birth injury (0.5% normal deliveries; 1.6% breech deliveries)		**Usually result from birth injury (0.5% normal deliveries; 1.6% breech deliveries)
	*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]		*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]

2020-06-13T17:38:48Z

Disposition

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	===Non-Newborn===		===Non-Newborn===
	*~~Type I (middle)~~		*Almost all may be discharged with orthopedic surgery follow-up (if no indications for immediate surgical management; see above)
	**Routine follow up ~~with primary care provider~~
	***Adequate even for ~~displaced and overlapping fracture~~		==Speciality Care==
	*Type II (lateral)		*For <12 years of age, almost all fractures are treated nonoperatively (due to high remodeling potential)
	*Depends on degree of displacement (routine follow up vs consult)
	**Significant displacement: ORIF
	*~~Type III~~ (~~medial~~)
	*Ortho consult

	==See Also==		==See Also==

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Non-Newborn

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	===Non-Newborn===		===Non-Newborn===
	*~~Type I (middle)~~		*Pain management
	**Arm [[sling]] ~~x 3-4wk~~		*Place the affected extremity in a [[Sling and swathe splint\|sling]] or shoulder immobilizer
	***Adequate even for ~~displaced and overlapping fracture~~
	*Type II (lateral)		*Orthopedic surgery consultation in the ED for:
	**Minimal displacement: ~~[[sling]]~~		**Displaced fracture with skin tenting
	**~~Significant displacement: ORIF~~		**Open fracture
	*~~Type III (medial)~~		**Neurovascular compromise
	**Anterior displacement: ORIF
	**~~Posterior displacement: emergent reduction~~

	==Disposition==		==Disposition==

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Diagnosis

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Background

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	==Background==		==Background==
	*Newborn		*Newborn
	**Usually result from birth injury		**Usually result from birth injury (0.5% normal deliveries; 1.6% breech deliveries)
	*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]		*Fracture in <2 year-old should raise possibility of [[Child abuse\|abuse]]

2020-06-13T17:20:10Z

Disposition

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	==Disposition==		==Disposition==
	===~~Neonatal~~===		===Newborn===
	*Discharge home		*Discharge home

	===~~Middle third~~===		===Non-Newborn===
	*Routine follow up with primary care provider		*Type I (middle)
			**Routine follow up with primary care provider
	~~===Medial===~~		***Adequate even for displaced and overlapping fracture
	*~~Ortho consult~~		*Type II (lateral)

	~~===Distal===~~
	*Depends on degree of displacement (routine follow up vs consult)		*Depends on degree of displacement (routine follow up vs consult)
			**Significant displacement: ORIF
			*Type III (medial)
			*Ortho consult

	==See Also==		==See Also==

2020-06-13T17:18:39Z

Non-Newborn

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	===Non-Newborn===		===Non-Newborn===
	*Type (middle)		*Type I (middle)
	**Arm [[sling]] x 3-4wk		**Arm [[sling]] x 3-4wk
	***Adequate even for displaced and overlapping fracture		***Adequate even for displaced and overlapping fracture
	*Type ~~(medial)~~		*Type II (lateral)
	**Anterior displacement: ORIF
	**Posterior displacement: emergent reduction by ortho or trauma
	*Type III (lateral)
	**Minimal displacement: [[sling]]		**Minimal displacement: [[sling]]
	**Significant displacement: ORIF		**Significant displacement: ORIF
			*Type III (medial)
			**Anterior displacement: ORIF
			**Posterior displacement: emergent reduction

	==Disposition==		==Disposition==

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Management

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	==Management==		==Management==
	===~~Neonatal~~===		===Newborn===
	*No treatment necessary		*No treatment necessary

	===~~Middle Third~~===		===Non-Newborn===
	*Arm [[sling]] x 3-4wk		*Type (middle)
	**Adequate even for displaced and overlapping fracture		**Arm [[sling]] x 3-4wk
			***Adequate even for displaced and overlapping fracture
	~~===Medial===~~		*Type (medial)
	*Anterior displacement: ORIF		**Anterior displacement: ORIF
	*Posterior displacement: emergent reduction by ortho or trauma		**Posterior displacement: emergent reduction by ortho or trauma
			*Type III (lateral)
	~~===Distal===~~		**Minimal displacement: [[sling]]
	*Minimal displacement: [[sling]]		**Significant displacement: ORIF
	*Significant displacement: ORIF

	==Disposition==		==Disposition==

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Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:Clavicle fracture 1.jpg\|thumb\|Right clavicle fracture.]]
			[[File:IMG 3824.jpg\|thumb\|Right clavicle fracture.]]
	===Newborn===		===Newborn===
	*Upper extremity palsy ([[brachial plexus injury]])		*Upper extremity palsy ([[brachial plexus injury]])
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	*Callous at clavicle during first 2-3wk of life		*Callous at clavicle during first 2-3wk of life

	===~~Middle Third fracture~~===		===Non-Newborn Presentation===
	*~~Most common~~		*Swelling, deformity, and tenderness overlying the clavicle
			*Affected arm may be supported by the contralateral arm

	===~~Medial clavicle fracture~~===		===Associated Injuries===
	*~~Rare~~		*Type I (middle)
	*~~If displaced anterior: tenderness~~ and ~~palpable protrusion of distal end~~		**Subclavian artery/vein injury
	*~~If displaced posterior: compression of trachea~~/~~esophagus possible~~		**Nerve root and/or brachial plexus injury
			*Type II (lateral)
	~~===Distal clavicle fracture===~~		**Coracoclavicular ligament injury
	*~~Rare~~		**AC joint dislocation/subluxation
	*~~Due to direct trauma~~		*Type III (medial)
			**Intrathoracic injury
			**Rib fracutre
			**Sternal fracture

	==Differential Diagnosis==		==Differential Diagnosis==