Clavicular fractures represent 2.6—5% of all fractures, with middle third fractures being the commonest. The shape of the clavicle bone is such that it has a flat medial and lateral expanses, linked by a thin, tubular middle. This central transitional area represents a weak link in clavicular structure, which is not protected by or reinforced with muscle or ligamentous attachments, therefore rendering it prone to fracture. Due to the subcutaneous position of the clavicle, there is an inherent susceptibility to direct injury. These fractures are easy to diagnose due to the presence of swelling and bruising present. Radiographical examination should include an anteroposterior and a 45° caudal tilt view. Optimal treatment in undisplaced or minimally displaced fractures is with a sling. In displaced or comminuted fractures the risk of non-union and poor functional outcome may be markedly higher and may be best treated with surgical fixation.
Allman Jr FL1967. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am49: 774-84.
2.
Anderson K.2003. Evaluation and treatment of distal clavicle fractures . Clin Sports Med22: 319-26, vii.
3.
Ballmer FT, Gerber C.1991. Coracoclavicular screw fixation for unstable fractures of the distal clavicle. A report of five cases. J Bone Joint Surg Br73: 291-4.
4.
Barbier O., Malghem J., Delaere O., Vande BB, Rombouts JJ1997. Injury to the brachial plexus by a fragment of bone after fracture of the clavicle. J Bone Joint Surg Br79: 534-6.
5.
Bernard Jr RN, Haddad Jr RJ1982. Enchondroma of the proximal clavicle. An unusual cause of pathologic fracture-dislocation of the sternoclavicular joint. Clin Orthop Relat Res167: 239-41.
6.
Canadian Orthopaedic Trauma Society.2007. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am89: 1-10.
7.
Craig EV1991. Fractures of the shoulder: Part II. Fractures of the clavicle . In Rockwood CA, Green DP, Bucholz RW eds. Rockwood and Green's fractures in adults, 3rd edn, Vol. 1, JB Lippincott: Philadelphia, PA, 928-90.
8.
Coupe BD, Wimhurst JA, Indar R., Calder DA, Patel AD2005. A new approach for plate fixation of midshaft clavicular fractures. Injury36: 1166-71.
9.
Edwards DJ, Kavanagh TG, Flannery MC1992. Fractures of the distal clavicle: a case for fixation . Injury23: 44-6.
10.
Flinkkila T., Ristiniemi J., Lakovaara M., Hyvonen P., Leppilahti J.2006. Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients. Acta Orthop77: 644-9.
11.
Fowler AW1968. Treatment of fractured clavicle. Lancet1: 46-7.
12.
Haidar SG, Krishnan KM, Deshmukh SC2006. Hook plate fixation for type II fractures of the lateral end of the clavicle. J Shoulder Elbow Surg15: 419-23.
Jubel A., Andermahr J., Schiffer G., Tsironis K., Rehm KE2003. Elastic stable intramedullary nailing of midclavicular fractures with a titanium nail. Clin Orthop Relat Res408: 279-85.
15.
Jupiter JB, Leffert RD1987. Non-union of the clavicle. Associated complications and surgical management. J Bone Joint Surg Am69: 753-60.
16.
Kona J., Bosse MJ, Staeheli JW, Rosseau RL1990. Type II distal clavicle fractures: a retrospective review of surgical treatment. J Orthop Trauma4: 115-20.
Moneim MS, Balduini FC1982. Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. A case report. Clin Orthop Relat Res168: 133-5.
19.
Neer CS1963. Fracture of the distal clavicle with detachment of the coracoclavicular ligaments in adults. J Trauma3: 99-110.
20.
Neer CS1968. Fractures of the distal third of the clavicle. Clin Orthop Relat Res58: 43-50.
21.
Nordqvist A., Petersson C.1994. The incidence of fractures of the clavicle. Clin Orthop Relat Res300: 127-32.
22.
Nowak J., Holgersson M., Larsson S.2004. Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg13: 479-86.
23.
Nowak J., Mallmin H., Larsson S.2000. The aetiology and epidemiology of clavicular fractures. A prospective study during a two-year period in Uppsala, Sweden. Injury31: 353-8.
24.
Postacchini F., Gumina S., De Santis P., Albo F.2002. Epidemiology of clavicle fractures. J Shoulder Elbow Surg11: 452-6.
25.
Robinson CM1998. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br80: 476-84.
26.
Robinson CM, Cairns DA2004. Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg Am86-A: 778-82.
27.
Rowe CR1968. An atlas of anatomy and treatment of midclavicular fractures . Clin Orthop Relat Res58: 29-42.
28.
Rumball KM, Da Silva VF, Preston DN, Carruthers CC1991. Brachial-plexus injury after clavicular fracture: case report and literature review. Can J Surg34: 264-6.
29.
Sankarankutty M., Turner BW1975. Fractures of the clavicle. Injury7: 101-6.
30.
Stanley D., Trowbridge EA, Norris SH1988. The mechanism of clavicular fracture. A clinical and biomechanical analysis. J Bone Joint Surg Br70: 461-4.
31.
Webber MC, Haines JF2000. The treatment of lateral clavicle fractures. Injury31: 175-9.
32.
Zlowodzki M., Zelle BA, Cole PA, Jeray K., McKee MD2005. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma19: 504-7.
