Clavicle fractures most commonly occur in the middle third of the clavicle and result from a direct impact to the shoulder. Physical examination involves inspecting for deformity and comparing to the opposite clavicle, as well as evaluating pain and instability. Radiographic imaging, including anteroposterior and 30-degree cephalic tilt views, is used to classify fractures by their location and degree of displacement. Treatment options include nonoperative management with slings and braces or surgical fixation using plates, screws, pins, or titanium elastic nails. Following treatment, physiotherapy focuses on education, rest, bracing, electrotherapy, taping, and graduated exercises to improve posture, flexibility, strength, and return to

1. Clavicle Fractures

2. EPIDEMIOLOGY
• Clavicle fractures account for 2.6% to 12%
of all fractures and for 44% to 66% of
fractures about the shoulder.
• Middle third fractures account for 80% of
all clavicle fractures, whereas fractures of
the lateral and medial third of the clavicle
account for 15% and 5%, respectively.

3. MECHANISM OF INJURY
Direct impact to the anterior - superior
shoulder of moderate – high force.
1. Fall from height
2. Motor vehicle accident
3. Sports injury
4. Blow to the point of the
shoulder
5.Rarely, a direct injury to the clavicle

4. Physical Examination
Inspection
–Evaluate deformity and/or displacement
–Beware of rare inferior or posterior
displacement of distal or medial ends of
clavicle
–Compare to opposite side.

5. Palpation
Evaluate pain
Look for instability with stress
Neurovascular examination

6. Radiographic Evaluation
of the Clavicle
Anteroposterior
View
30-degree Cephalic
Tilt View

7. Classification
• Craig’s classification.
• Group I: fracture of the middle third
(80%).
• Group II: fracture of the lateral one
third(15%).
• This is subclassified according to the
location of the coracoclavicular ligaments
relative to the fracture:

8. • Type I: Minimal displacement:
interligamentous fracture between the
coracoclavicular and AC ligaments;
ligaments still intact
• Type II: Displaced secondary to a fracture
medial to the coracoclavicular ligaments:
higher incidence of nonunion
• Type III: Fracture of the articular surface
• Type IV: ligament intact to the periostium,
with displacement of proximal fragment
• Type V: communited

9. • Group III: fracture of the medial one third
(5%).
• Type I: Minimal displacement
• Type II: Displaced
• Type III: Intraarticular
• Type IV: Epiphyseal separation
• Type V: Comminuted

10. Treatment Options
Nonoperative
–Sling
–Brace
Surgical
–Plate Fixation
–Screw or Pin Fixation
–Titanium elastic nails (usually
inserted medial to lateral)

11. Physiotherapy for a clavicle
fracture
• Physiotherapy treatment for patients with
this condition is important to ensure an
optimal outcome and allow a safe return to
activity. Treatment may comprise:
• education
• rest from aggravating activities
• the use of a sling or figure-of-8 bandage
• electrotherapy

12. • protective and postural taping
• exercises to improve posture, flexibility
and strength
• activity modification advice
• a graduated return to activity plan
• soft tissue massage
• joint mobilization

13. Thank You