Orthopedics - Clavicle fractures, AC joint injuries, and
associated injuries
1. What is tenting?: - displaced clavicle fracture that makes the skin "poke up" and is conc erning because it
can cut through the skin
2. Which part of the clavicle is most commonly fractured?: - mid shaft of clavicle
3. What is the MOI of a clavicle fracture?: - fall on outstretched shoulder, or blow to clavicle, with
pain and inability to raise arm
4. What are PE findings of a clavicle fracture?: - swelling and ecchymosis overlying the injured
clavicle
- pain and crepitation upon palpation of the fracture site
- pain and limited ROM of the arm, especially in forward flexion and abduction
5. What is the treatment for clavicle fractures?: 1. Sling and support for 3-4 weeks, then
discontinue
2. IF severely displaced and/or comminuted fractures, may have to REFER to ORTHO for ORIF, especially if younger or
very active
6. What is the prognosis for clavicle fractures?: - RARELY associated with neurovascular damage
1/3
, - most heal very well
Do NOT start exercises early, as this leads to nonunion
- only return to play once shoulder strength and ROM are back to pre-injury levels (clinical AND radiological union are
evident)
7. What is the MOI for AC joint injuries?: - direct blow downward to tip of shoulder
8. What are symptoms of AC joint injuries?: - pain at trauma site
- pain with forward elevation of the arm
9. What appears on PE for AC joint injuries?: - visible elevation or displacement of the clavicle
relative to the acromion (asymmetric to the contralateral shoulder)
- pain and swelling over the AC joint
- athletes may leave field holding arm close to their side
- obvious deformity at AC joint
10. What should you always rule out with AC injuries?: - clavicle fracture with gentle palpation
at midshaft of clavicle
2/3
associated injuries
1. What is tenting?: - displaced clavicle fracture that makes the skin "poke up" and is conc erning because it
can cut through the skin
2. Which part of the clavicle is most commonly fractured?: - mid shaft of clavicle
3. What is the MOI of a clavicle fracture?: - fall on outstretched shoulder, or blow to clavicle, with
pain and inability to raise arm
4. What are PE findings of a clavicle fracture?: - swelling and ecchymosis overlying the injured
clavicle
- pain and crepitation upon palpation of the fracture site
- pain and limited ROM of the arm, especially in forward flexion and abduction
5. What is the treatment for clavicle fractures?: 1. Sling and support for 3-4 weeks, then
discontinue
2. IF severely displaced and/or comminuted fractures, may have to REFER to ORTHO for ORIF, especially if younger or
very active
6. What is the prognosis for clavicle fractures?: - RARELY associated with neurovascular damage
1/3
, - most heal very well
Do NOT start exercises early, as this leads to nonunion
- only return to play once shoulder strength and ROM are back to pre-injury levels (clinical AND radiological union are
evident)
7. What is the MOI for AC joint injuries?: - direct blow downward to tip of shoulder
8. What are symptoms of AC joint injuries?: - pain at trauma site
- pain with forward elevation of the arm
9. What appears on PE for AC joint injuries?: - visible elevation or displacement of the clavicle
relative to the acromion (asymmetric to the contralateral shoulder)
- pain and swelling over the AC joint
- athletes may leave field holding arm close to their side
- obvious deformity at AC joint
10. What should you always rule out with AC injuries?: - clavicle fracture with gentle palpation
at midshaft of clavicle
2/3
