top of page

Outlines current management of upper limb conditions in primary care settings

This information is for primary care physicians and a general summary of current practice 

Please consult a physician directly for management of specific injuries  

Mid-Shaft Clavicle Fractures 

Indications for Operative Management

Mechanism of Injury:  Fall onto outstreched hand or direct fall onto shoulder

Associated injuries: Brachial Plexus Injuries, Rib fractures, Pneumothorax, Scapula Fractures

Note: Clavicle fractures are a debated topic, and management guidelines vary between specialists

Clavicle fractures are categorized as medial third, middle third and lateral third

Lateral clavicle fractures are categorised with AC joint injuries. They have a higher non-union rate and often require surgery or a surgical opinion 



Considerations for Primary Care Clinicians

  • Thorough assesment ofthe skin overlying the clavicle

  • Assessment of co-existing injuries

    • ribs, scapula

    • brachial plexus

  • Some patients with rib fractures or pneuothorasis may require admission for pain and respiratory management

Indications for Surgical Management 

  • Compound fracture

  • Threatening of skin (visible pressure on the skin from the fracture)

  • All other indications are relative (see case study)

  • Considerations:

    • displacement - especially shortening (some evidence of  > 2cm has a less desirable outcome)

    • Patient factors (age, activity level, co-morbidities)

Please refer patient to a ULQ fellowship trained hand surgeon for management 
bottom of page