- If there is neurovascular compromise, an open fracture, or tenting of the skin, consult orthopedics immediately.
- Assess for polytrauma, particularly scapula fractures, rib fractures, pneumothorax, and hemothorax, and treat per protocol.
Classic history and presentation: A clavicle fracture is often a sports injury. The typical patient is a high school football player presenting to the ED after an injury on the field, falling on the lateral aspect of the shoulder while being tackled. The patient may feel a "pop" before experiencing pain in the shoulder and/or collarbone. Range of motion of the shoulder may be limited by pain, and the patient may keep their arm adducted and internally rotated.
- Age – Patients are usually either active young adults (typically younger than 30 years) or older than 55 years.
- Sex / gender – Clavicle fracture is more common in males.
- Contact sports
- Fall onto an outstretched hand
- Motor vehicle trauma
- Advanced age
Grade / classification system: Classified by location, fracture pattern, and integrity of stabilizing ligaments:
- Medial (proximal) third:
- Complete articular
- Middle third:
- Multifragmentary / comminuted
- Lateral (distal) third:
- Nondisplaced, coracoclavicular (CC) ligaments intact
- Displaced, CC ligaments intact
- Displaced, CC ligaments disrupted