Dr. Ebraheim’s educational animated video describing the condition of clavicle bone fractures in children,causes, diagnosis and treatment in an easy and simple way.
The clavicle is the first bone to ossify. The shaft of the clavicle ossifies in membrane and not in cartilage from the two primary ossification centers. The medial end of the clavicle ossifies in cartilage from one secondary ossification center. The secondary center appears at 17-18 years of age and fuses with the shaft at about 22 years of age.
Fractures of the clavicle location:
•Medial 1/3: 5%
•Middle 1/3: 85%
Clavicle fracture types
1-Clavicle birth fracture: 95% of birth-related injuries involve the clavicle. Injury is usually associated with breech deliveries and large babies. Fracture may causes pseudoparalysis. Rule out brachial plexus injury. Reflexes remain intact following isolated clavicle fractures.
2-Pseudoarthrosis: involves the right clavicle. When fracture occurs on the left side look for dextrocardia. There will be no callus formation and there will be a rounded appearance of the two ends. The fracture will not heal by itself. Surgery may be needed for function or for pain. A bone graft and fixation is usually needed.
3-Clavicle fracture in children: the majority of fractures occurs from falls in younger aged individuals or from sports-related in older children. When the fracture occurs in the diaphysis, it usually heals with minimal deformity. There will be excellent healing in 6 weeks with return to non-contact sports. In 3 months the patient will be able to return to contact sports. Diaphyseal greenstick fracture of the clavicle is a common type of fracture. Greenstick fractures have excellent remodeling and always heal with no clinical problems. Fracture of the proximal clavicle occurs in children with an open physeal growth plate. Most of their injuries are classified as Salter-Harris I or II. Posterior dislocation of the clavicle may warrant reduction due to associated complications. if the proximal fracture is displaced posteriorly, a hollow is evident. This may cause difficulty in swallowing and breathing. If the proximal fracture is displaced anteriorly, the proximal end is palpable. When the fracture occurs in the distal third, the distal clavicle is stripped away from the physis and periosteal sleeve. Both physis and periosteal sleeve remain attached to the AC and CC ligaments. A new clavicle will remodel from the periosteal sleeve and the displaced clavicle will be resolved with time. Treatment: sling brace is just as good as a figure eight clavicle splint. Patients may need follow-up x-rays. Surgery is rarely needed in children.
Adolescence who sustain a displaced fracture or shortening may require surgical treatment. Be aware that the fracture in adolescence may become displaced. Early follow-up with x-rays is needed.
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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step