In this section
See also: Clavicle fractures - Emergency Department
Table 1: Recommended follow-up schedule for clavicle fractures.
Subsequent review appointments
Discharge advice to parents
Middle third (≥11 years or displaced)
At 7 days post-injury. Repeat x-ray is usually not required
Advise parents to remove sling at 2 weeks
At 4 weeks post-injury. Repeat x-ray not required
A lump may be felt at the fracture site, which may be visible. The lump will decrease as remodelling occurs. It is more complete in younger patients
Lateral third (undisplaced)
At 5-7 days post-injury with x-ray.
At 2 weeks post-injury with x-ray
Remove sling at 2 weeks if no displacement
4 weeks post-injury
For undisplaced fractures, a lump usually does not develop
Contact sports and activities should be avoided for approximately 6 weeks post removal of sling
Review is based on assessing for neurovascular compromise, loss of position and guiding exercise and return to activities.
Lateral third fractures require regular x-ray to detect loss of position or instability.
For middle third fractures, loss of position is not a factor. Review is for clinical evidence of callus formation and stability to allow return to movement. This usually occurs at four weeks.
Surgery may be indicated if skeletally mature or shortening >2 cm.
Indications for a consultant orthopaedic surgeon opinion are:
Patient can be discharged (usually at four weeks) when:
Hunter JB. Fractures around the shoulder and humerus. In Children's Orthopaedics and Fractures,3rd Ed. Benson M, Fixsen J, Macnicol M, Parsch K (Eds). Springer, London 2010. p.717-30.
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