The clavicle is the strut connecting the upper limb to the axial skeleton, transmitting upper limb forces to the sternum through the SC joint. Its S-shaped curve and tubular cross-section distribute loads efficiently. The middle third is the weakest point, the most common fracture site (80% of clavicle fractures). The clavicle has the first ossification centre to appear in the embryo (5-6 weeks) and the last epiphysis to fuse (medial physis at 22-25 years).
An expanded entry for Clavicle.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | First long bone to ossify (membranous ossification from two primary centres at 5-6 weeks). Medial physeal closure at 22-25 years, the last major epiphysis to fuse. |
Midshaft clavicle fractures with greater than 2 cm shortening, complete displacement with no cortical apposition, or associated neurovascular injury require surgical fixation (plate or intramedullary pin). Non-operative management in a sling produces malunion in 15-25% of completely displaced fractures. Distal clavicle fractures associated with CC ligament rupture (Type II) require fixation.
Usually in the middle third from a fall onto the shoulder; most heal with a sling, though displaced fractures may need fixation.
A fall onto the point of the shoulder tears the AC and coracoclavicular ligaments, so the lateral clavicle rides up.
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