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  • Q&A with Australian Health Practitioners

    What sort of care will my son need for a 30° fracture in his clavicle?

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    Orthopaedics
    My 10 year old son fractured his left clavicle a week ago and the doctor has just put his arm in a sling. We got the report back and it shows a 30° break and she is now unsure of the best course of action. It will take weeks to get an appointment at the closest fracture clinic so should I take him to emergency and get a specialist to look at it?
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    Dr Simon Chan

    Hand Surgeon, Orthopaedic Surgeon

    Dr Chan obtained his medical degree from the University of Sydney. In 1998, he was awarded the Zimmer Research Fellowship at the Jo Miller Laboratory … View Profile

    Dear Amanda

    This advice is general as I have not seen the actual x-rays.

    I liken fractures to skin cuts.

    If I cut myself, the skin will bleed, form a crusty scab, and heal. If I cut myslelf badly, and the wound is gaping open, I can dress the wound regularly, and it will still heal, possibly with a wide and ugly scar. It may heal better, if someone puts the edges together and holds them together with stitches. The stitches don't make my skin heal, they just hold the wound edges together while the skin heals itself.

    When bone breaks, it also bleeds. It forms a "softish scab" around the bone fragments. In general, the bone will heal without surgery (with some important exceptions). As orthopaedic surgeons, we operate on some fractures to improve the position of the fracture, and/or hold the fracture in position as it heals up. In general, our operations do not make the fracture heal.

    The collar bone (clavicle) is the classic example of a fracture that heals without intervention (again, with some exceptions). The majority of clavicle fractures do not require surgery. The other important variable in your situation is your son's age. As he grows, the bend in the bone will straighten. A 30 degree bend will most likely become straight over the next 2 years. In the meantime, he will have a bit of a bump to show off to his friends.

    It is extremely uncommon for a 10 year-old to need surgery for a clavicle fracture. All he should need is a sling. The sling is mainly for comfort, to remind him to take of the arm, and to remind his 10 year-old friends as well. In reality, it will barely slow him down after a couple of weeks. At 10, he will not need any physiotherapy, he will just do what 10 year-olds do. I would avoid contact sports, skateboards, trampolines, monkey bars etc for 10 to 12 weeks.

    If you or your GP are still uncertain, get a referral to see an orthopaedic surgeon in their office. A trip to the Emergency Department for a closed clavicle fracture will usually be categorised as low priority and result in a long wait. You may not even see an orthopaedic doctor and be referred to their next available fracture clinic. Unfortunately, that's just how it is in most hospitals.

    Hope this has been helpful.

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    Ash Chehata

    HealthShare Member

    In general clavicle fractures will almost all heal and even straighten at that age.

    If you are uncertain a trip to the local orthopaedic surgeon with  a new x-ray will confirm the healing and usually you will be left with a lump that will straighten up with time

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