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Audience: Students in Health Care By Stephen Altano

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The medical portion of the Clavicle attaches to the sternum The Lateral portion attaches to the acromion process of the scapula Respectively comprising the acromioclavicular and sternoclavicular joints

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Prevents anterior displacement of the scapula Enables full range of motion of the arm The Medial epiphysis is the last to ossify Fuses at about 25 years old The superior portion is not protected by muscle, making it vulnerable to injury

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The clavicle is most commonly fractured where the concave portion meets the convex Mechanisms include; Falling on tip of shoulder Falling on outstretched arm Direct impact Clavicle fractures occur most commonly during Contact Sports Is of the most common sports fracture Football Fracture Video Example Football Fracture Video Example

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Did you hear any sounds? I HERD A CRACK!

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Athlete will describe a related mechanism Complain of hearing a crack and crepitus Have severe pain along the shaft of the clavicle Can present neurological symptoms due to underlying neurovascular systems Medical Emergency

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Patient will be guarding Holding arm with head tilted towards involved side Obvious deformity will be present Edema and ecchymosis

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All Motions will be limited Patient will be apprehensive towards any movement Strength testing is contraindicative Percussion tests will be positive

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Ice Sling and Swathe Send to Emergency Room X-Rays

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Most fractures are treated without surgery Surgical Techniques Plates and Screws Pins

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Indications for Surgery Neurovascular compromise Excessive raised skin Open fracture Associated scapular fracture

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Patient should be immobilized for up to six weeks Can begin Range of motion exercises during immobilization period All exercises should be pain free Strength exercises should begin with isometrics and progress as motion is improved

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Should be progressed based on symptoms and pain free activity Therapeutic Modalities Ice Compression Effleurage Electric Stimulation Ultrasound Range of motion exercises Passive Active Assistive

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Cardiovascular endurance Stationary bike Treadmill Strength Exercises Therabands Manual resistance Free weights Plyometrics Functional Activities Sport or Job specific

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DDepends on type of fracture and patient TTypically 6 weeks for non-contact activities UUp to 12 weeks for contact sports IImportant to Remember each case is unique

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Full range of motion Strength is equal to uninvolved limb No point tenderness over fracture site Able to perform functional testing Cleared by a physician Psychologically ready

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Ashwood N, Moonot P. Clavicle fractures. Trauma. 2009;11:123-132. Houglam PA. Therapeutic Exercise For Musculoskeletal Injuries. 3 rd ed. Champaign, IL: Duquesne University; 2010. Pujalte GGA, Housner JA. Management of clavicle fractures. Current sports medicine reports. 2008;7:275