By a direct blow, the clavicle can be fractured in contact sport, by motor vehicle accident, or by newborn birth trauma from shoulder dystocia.

Common findings include swelling, deformity, and point tenderness over the clavicle, which is subcutaneous and easily palpable.

Always listen to the chest to make sure there is no pneumothorax related to the clavicle fracture, especially for those fractures caused by motor vehicle accidents. Instruct the patient to let you know immediately if he or she has any shortness of breath.

Radiographic imaging includes anteroposterior as well as cephalic and caudal tilt views to assess displacement.

Treatment is symptomatic and includes a figure-of-eight brace or sling, both, or neither, depending on the patient’s comfort level. If the patient is comfortable in the sling, then a figure-of-eight brace is not needed if the clavicle fracture is nondisplaced. The goal is to restore anatomic alignment and length of the clavicle. If the clavicle fracture is overriding (bayonet position), reduction is necessary with a figure-of-eight splint. If this is not done, the fracture will heal with a shortening. This results in foreshortening of the shoulder and poor cosmesis.