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Key Features

  • Injury by fall on to shoulder or outstretched hand or by direct trauma

  • Severe pain in the shoulder

  • Fracture nonunion is unusual in young patients

  • Athletes cannot return to contact sports for 8–12 weeks

Clinical Findings

  • Focal swelling, deformity, and tenderness are present over the clavicle


  • Diagnosis is made by radiographs of the clavicle

  • Fractures are most common in the middle third of the bone


  • Initial treatment is focused on pain control and protection with a sling and swathe

  • Early range of motion is permitted based on pain level

  • Progressive rehabilitation is important

  • Absolute surgical indications for acute clavicular fractures include open fractures or neurovascular compromise

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