Clavicular Fracture: Pathogenesis and clinical findings
Multisystem Repetitive stress Fall onto shoulder Fall on outstretched Direct blow from trauma (e.g. MVC) (e.g. rowing) (87%) hand (6%) an object (7%) • • Acute fracture Stress fracture

Proximal third Group III (2.8%)
Undisplaced fracture
•
Shape of clavicle undergoes minimal change
Legend:
Middle third (mid-shaft) Group I (69%)
Clavicular Fracture
Displaced medial and lateral segments
Sternocleidomastoid muscle pulls the medial segment up
•••-•••11
Anterior Shoulder Pain
Pathophysiology Mechanism
Distal third Group II (29%)
Fracture is medial or lateral to the coracoclavicular ligaments
Pectoralis muscle and weight of arm pulls the lateral segment down and towards midline
Sign/Symptom/Lab Finding
Complications
Lateral Shoulder Pain
Authors: Jack Fu Reviewers: Reza Ojaghi Usama Malik Aaron J. Bois* * MD at time of publication
Notes: • There is no correlation between the mechanism of injury and the site of fracture (i.e., which “third” is involved). It is important to perform a neurovascular and respiratory examination looking for other injuries in all patients with clavicle fractures, particularly if higher forces were involved (eg, motor vehicle collision).