- Clavicle Frx in Infants:
- 95% of birth frxs involve the clavicle and are associated w/ breech deliveries;
- diff dx:
-
congential pseudoarthrosis of clavicle:
-
brachial plexus injury
- pseudo-paralysis which follows clavicular frxs may be distinguished from
brachial plexus injury,
because reflexes remain intact following isolated clavicle fractures;
- proximal humeral epiphyseal separation;
- associated injuries:
-
brachial plexus injury
- pneumothorax
- vascular injuries;
- clavicular birth fractures heal rapidly.
- Clavicle Frx in Children:
- 80% of fractures occur in midshaft;
-
distal clavicular physeal separation:
- childhood equivolent to adult AC separation;
- clavicle is stripped away from physis and periosteal sleeve, both of which remain attached
to the AC and CC ligaments;
- a new clavicle will remodel from the periosteal sleeve whereas the displaced clavicle
will be reabsorbed w/ time;
- in young children most of bony prominence will be incorporated w/ growth;
- Treatment:
- older children can be managed w/ sling or figure-eight dressing;
- adolescents may be left w/ small bony prominence;
- surgical intervention is rarely indicated;
The apical oblique view of the clavicle: its usefulness in neonatal and childhood trauma.
