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
Slide 21
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