What are the clinical signs and symptoms of clavicle fractures?

Updated: Jan 14, 2019
  • Author: Benjamin P Kleinhenz, MD; Chief Editor: Craig C Young, MD  more...
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Clinical signs and symptoms of clavicle fracture include the following:

  • The patient may cradle the injured extremity with the uninjured arm

  • The shoulder may appear shortened relative to the opposite side and may droop

  • Swelling, ecchymosis, and tenderness may be noted over the clavicle

  • Abrasion over the clavicle may be noted, suggesting that the fracture was from a direct mechanism

  • Crepitus from the fracture ends rubbing against each other may be noted with gentle manipulation

  • Difficulty breathing or diminished breath sounds on the affected side may indicate a pulmonary injury, such as a pneumothorax

  • Palpation of the scapula and ribs may reveal a concomitant injury

  • Tenting and blanching of the skin at the fracture site may indicate an impending open fracture, which most often requires surgical stabilization (see the image below)

    Comparison of both clavicles, with the left tentin Comparison of both clavicles, with the left tenting the skin (wide arrow).
  • Nonuse of the arm on the affected side is a neonatal presentation

  • Associated distal nerve dysfunction indicates a brachial plexus injury

  • Decreased pulses may indicate a subclavian artery injury

  • Venous stasis, discoloration, and swelling indicate a subclavian venous injury [2, 3]

See Clinical Presentation for more detail.

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