Clavicle fracture: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Thoracic trauma DDX}} | {{Thoracic trauma DDX}} | ||
{{Shoulder DDX}} | |||
==Management== | ==Management== | ||
Revision as of 04:57, 18 February 2015
Background
- Occurs via direct blow to shoulder
- Middle third: 80%
- Distal third: 15%
- Medial third: 5%
Clinical Features
- Swelling, deformity, and tenderness overlying the clavicle
- Arm is supported by the other extremity
- Distal fx often assoc w/ coracoclavicular ligament rupture
- Medial fx often assoc w/ intrathoracic injuries
Imaging
- Routine imaging may miss some fractures (particularly at either end of the bone)
- CT may be required for definitive diagnosis
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Management
- Consult ortho for:
- Open fx or persistent skin tenting
- Comminution
- Displacement
- Sling
See Also
Source
- Tintinalli