Pediatric ClaviclePosted on: January 9, 2020, by : Haroon Shaukat MD
- Medial: Rare injury to medial physis, considered childhood equivalent to adult sternoclavicular separation.
- Anterior Displacement – patients head may be tilted towards affected side
- Posterior Displacement – innominate artery and vein, internal jugular vein, phrenic and vagus nerves, trachea, and esophagus may be injured
- Distal: Rare injury to distal physis, considered childhood equivalent to adult acromioclaviclular separation.
- Shaft: common, mostly traumatic but occasionally from birthing deliveries.
- associated injuries are rare but include neurovascular or brachial plexus injuries
- Exceedingly rare:
- Persistent instability/nonunion (1-5%)
- Laceration of subclavian artery or vein
- Acromioclavicular (AC) Separation
- traumatic injury to the AC joint with disruption of the acromioclavicular ligaments and/or coracoclavicular ligaments. (NOT A FRACTURE)
- Consider obtaining bilateral views and compare displacement of contralateral shoulder
- Nonoperative: brief sling immobilization, rest, ice, physical therapy with early ROM
- Operative: only in severe tears with skin tenting or severe shoulder droop that does not improve with shrugs
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