J Korean Fract Soc.  2018 Jan;31(1):22-28. 10.12671/jkfs.2018.31.1.22.

Conservative Treatment of Mid-Clavicle Fractures

• Jeong WK

• KMID: 2402711
• DOI: http://doi.org/10.12671/jkfs.2018.31.1.22

Abstract

Clavicle fractures are very common injuries in adults and children and the majority of these fractures occur in the midshaft. Traditionally, mid-clavicle fractures have been treated with conservative methods and the clinical outcomes of this method are believed to be excellent. On the other hand, recent studies have shown that the clinical results of severe comminuted or markedly displaced fractures after conservative management were not as favorable as previously described. Despite these concerns, the conservative treatment of mid-clavicle fractures is still an efficient method, which can be applied to all patients as a primary care. This review focuses on the proper indication, technique, and limitations of conservative treatment of mid-clavicle fractures.

Keyword

Shoulder; Clavicle; Fracture; Conservative treatment

MeSH Terms

Adult
Child
Clavicle
Hand
Humans
Methods
Primary Health Care
Shoulder

Figure

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  Fig. 1. Plain radiographs to evaluate mid-clavicle fractures. (A) Anterior-posterior projection: shortening of the clavicle and drooping of the shoulder girdle is prominent in this view. (B) Caudal tilting view: Anterior-posterior displacement is prominent in this view. (C) Cephalad tilting view: S shape of clavicle is prominent in this view.

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  Fig. 2. A 47-year-old woman suffered a left mid-clavicle fracture. (A) Initial anteroposterior radiograph shows minimal cortical contact between the fracture fragments. (B) There is no evidence of fracture healing 6 months after conservative treatment. (C) Plain radiographs taken 1 year after plate fixation and bone graft shows solid bone union.

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  Fig. 3. An 82-year-old woman suffered a left clavicle fracture. (A) Non-union was observed after conservative treatment 9 months after the initial trauma. (B) Although her clavicle fracture had not healed, she had an acceptable appearance. (C) She also shows good shoulder function (She permitted printing her face and photos in this journal.).

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  Fig. 4. A 21-year-old man suffered a right clavicle fracture. (A) Initial radiographs shows some cortical contact between the fracture fragments but shortening of the clavicle is visible. (B) Plain radiographs taken 1 year after trauma shows shortening of the clavicle and different versions of glenoid fossa. (C) One year after trauma, his clinical photos shows prominent fracture site and drooping of the right shoulder girdle. He was not satisfied with the outcome.

Reference

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