upper limbs-1

FRACTURES OF THE CLAVICLE AND SHOULDER GIRDLE

Clavicular fractures

These are common injuries in adults and children about 10% of all fractures.
The majority of cases follow a fall on the shoulder.
Most fractures involve the middle third of the bone.

Popular classification:

Group I: refers to middle third fractures.
Group II: refers to lateral third fractures, which in turn are divided into three types.
1-CC ligament is intact.
2- CC ligament torn with high riding of the fractured end of clavicle.
3- Intra articular fracture that extends into the ACJ.
Group III: refers to medial third fractures.


Dx

Clinical diagnosis is not difficult in most cases - there is tenderness with visible and palpable deformity at the site of the fracture.
A small percentage of these patients have high-energy trauma and in these cases there is an association with brachial plexus injuries and vascular injury.
Clinical assessment should include an assessment of the neurovascular status of the upper limb.