Clavicle Middle Third

corpus claviculae, pars media

The middle third of the clavicle is the most common fracture zone, accounting for approximately 70-80% of all clavicle fractures, because it is the most slender portion of the S-shaped bone and is subjected to bending and torsional forces during falls on the outstretched hand or direct shoulder trauma. The muscle attachments change at the middle-lateral junction (deltoid laterally, trapezius medially, sternocleidomastoid medially to proximal third), creating differential displacement forces in midshaft fractures.

Region: Chest

Clinical Relevance

Clinical Notes

Clavicle midshaft fractures are the most common fractures in children and young adults. The typical displacement pattern has the medial fragment elevated by sternocleidomastoid and the lateral fragment depressed by the arm weight plus pectoralis minor. Most are treated conservatively with a sling or figure-eight bandage, with surgical fixation reserved for completely displaced shortening over 2 cm, open fractures, neurovascular injury, or polytrauma. Plate fixation (anterosuperior or anterior) or intramedullary nailing provides excellent union rates.

Pathology

Common Injuries & Conditions

Displaced Clavicle Midshaft Fracture

Clavicle middle-third fracture with more than 2 cm of shortening or complete displacement has a higher non-union rate with conservative treatment and significantly reduced shoulder strength and endurance; plate fixation or intramedullary nailing achieves union in over 97% of cases with faster return to activity compared to sling treatment for significantly displaced fractures.