In newborns, in most cases, a medical examination is sufficient to diagnose a previous clavicle fracture. X-ray diagnostics is rarely necessary. The orthopedist diagnoses a collarbone fracture on the basis of an interview and clinical examination.
X-ray examination is necessary to confirm the diagnosis and determine the degree of fracture displacement. In the case of very complicated, multi-fragmented fractures, it may be necessary to extend the diagnostics to include computed tomography.
What are the treatments for a collarbone fracture?
An uncomplicated clavicle fracture in a newborn does not require any specialist treatment. Conservative treatment with immobilization is indicated in most cases of collarbone fractures in children and adolescents, even if the fracture has been dislocated. In the course of growth, the collarbone has a chance to rebuild into the correct shape after fracture.
Only significantly displaced clavicle fractures, where fractures tighten the skin, and when the expected time to complete growth is short (at the age of 12–13 years and later), require surgery in children. The most commonly used stabilization is a special flexible intramedullary rod (the so-called TEN rod).
In adults (and adolescents after the end of growth), immobilization is used to treat non-displaced and slightly displaced fractures – there are specific guidelines regarding the distance between the fractures and possible shortening of the collarbone, which can be left without surgery.
Significantly displaced fractures that tighten the skin or simultaneous fractures of both collarbones are qualified for surgical treatment. After the growth is completed, stabilization with a plate and screws is applied. Both in children and adults, various forms of immobilization are used in the case of indications for inoperable treatment.
They are used:
- octal dressings (both soft and plaster),
- shoulder orthoses (“vests”),
- Dessault casts (covering the entire chest and one upper limb).
The superiority of any of these fixtures over the others has not been proven – the treatment results for all of these fixes are approximate. The orthopedist selects such a dressing individually, taking into account the patient’s comfort.
After treatment for a collarbone fracture, adults, whether surgical or immobilized, often require rehabilitation to regain full limb function. Rehabilitation is very rarely necessary in children.
What is the prognosis for a collarbone fracture?
In newborns, if the collarbone fracture was not complicated by nerve damage, the prognosis is excellent, the fracture does not leave a trace. In children, collarbone fractures heal well and leave no permanent consequences, even if they require surgery. The prognosis is good in the majority of adults who follow medical recommendations and then receive adequate rehabilitation. In rare cases, patients may develop problems with fracture healing.