Clavicle fractures usually occur in the segment comprising the middle third of
the clavicle and are caused by a violent impact to the arm, which can be extended
during the impact or fall, or by direct fall onto the shoulder.
After the fall, the sternocleidomastoid muscle elevates the medial fragment of
the bone, while the trapezius muscle is unable to keep the lateral fragment
elevated, resulting in the shoulder drooping under the weight of the arm. The
pectoralis major and the adductor muscles pull the distal fragment, making them
override the proximal. Dislocation is rare, as the acromioclavicular ligament
usually prevents it.
Symptoms
Shoulder pain and antepulsion due to the overriding of the fractured fragments,
as a result of muscle-tendon tension.
The injury often occurs during sporting activities and work or traffic accidents.
In the majority of cases, it occurs in the middle third of the bone, and less
frequently in the distal third.
Orthotic Treatment
In the event of being open or displaced fractures, surgery and subsequent
rehabilitation is the required treatment. Immobilisation and realignment of the
fracture in conservative treatments can be achieved with the use of adjustable
textile orthoses or figure-of-eight devices that completely immobilise and retropulse
the shoulders in order to realign the fractured segment.
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