![]() Comminuted fracture (use buttress plate).Movement of the shoulder and the arm is not a risk factor for nonunion. The fracture will probably heel with a small bump (callus of healing). Used for minimally or nondisplaced fractures of the clavicle. if the fracture is significantly displaced, then there is a higher incidence of nonunion and this displaced fracture can cause significant, persistent weakness and disability even if the fracture heals. Healing will occur despite the degree of displacement. It is difficult to reduce and maintain reduction in clavicle fractures. ![]() Patient with undisplaced clavicle fractures usually heals well. The majority of patients improve spontaneously.Ĭonservative treatment: most clavicle fractures can be treated without surgery. Fracture of the lateral third of the clavicle with displacement of the medial fragment.Ībsolute indications for surgery: open fracture, vascular injury and fragment is tenting the skin. Risk factors for nonunion: smoker, older female, displacement and comminution. In the x-rays, you are going to look for shortening, comminution and the z-type fracture. Be aware that the neurovascular bundle is very close to the clavicle (subclavian vessels are about 1 cm from the clavicle).Check for possible neurovascular deficit (check for brachial plexus injury).May have scapulothoracic dissociation.Check for deformities and tenting of the skin.The sternocleidomastoid muscle will pull the medial fragment superiorly and the pectoralis muscle with gravity and the weight of the arm will pull the distal fragment inferiorly. Type III: fracture extends into the AC joint.Consider surgery for type II displaced fracture of the lateral third of the clavicle. This is the fracture type that is displaced and has disruption, it is the least stable fracture type and has the highest risk of nonunion. The lateral fragment may contain the ligaments entirely and the medial fragment displaces superiorly. they are either torn or the fracture is medial to the ligaments. ![]()
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