clavicle fracture classification
Fracture and Dislocation Classification Compendium–2018, Journal of Orthopaedic Trauma. In 1967 Allman8described the following classification system for all clavicle fractures based on location: Group I represented fractures of the middle third, which was the most frequent site of fracture (80%). Comminuted Transverse- Line of Fracture is transverse. Middle 1/3 fractures 2. Fractures of the middle third, or midshaft, are the most common, accounting for up to 80% of all clavicle fractures. Transverse 2. to the undersurface of the medial clavicle at its costal tuberosity, and this insertion is often mistaken for medial clavicle fractures (Figure 5) [4]. Clinical signs and symptoms of clavicle fracture include the following: 1. Crepitus from the fracture ends rubbing against each other may be noted with gentle manipulation 6. Type I – Minimally displaced / interligamentous. Type A. A1 when the … Sambandam B, Gupta R, Kumar S, Maini L. Fracture of distal end clavicle: A review. The most common mechanism of injury is a fall onto the shoulder or onto an outstretched hand. (2020) RadioGraphics. AO Principles of Fracture Management. Most classification schemes for clavicle fractures divide them into three basic categories. IIA : Conoid and trapezoid attached to distal fragmetnt 2. INTRODUCTION Clavicle one of the most commonly fractured bones 2.6% - 5% of all fractures 35% - 45% of shoulder girdle fractures Postacchini F, Gumina S, De Santis P, Albo F: Epidemiology of clavicle fractures.J Shoulder Elbow Surg 2002;11:452-456. Neer et al. C2 when the fracture is intra-articular, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The most commonly encountered fractures, those of the middle third or midshaft of the clavicle, are classified as group I. Fractures of the distal third or acromial end of the clavicle are classified as group II, and fractures of the medial third or sternal end are classified as group III. 15% of clavicle fractures 3. Fractures of the clavicle can be classified by its anatomical location (Table 1): Table 1: The most common type of fracture occurs when a person falls horizontally on the shoulder or with an outstretched hand. - See: - Clavicular Frx in Children / Congential Pseudoarthrosis of Clavicle - AC joint / Sternoclavicular Joint Injury / Scapula Fracture - Discussion and Classification - Exam Findings: - brachial plexus - ref: Injury to the brachial plexus by a fragment of bone after fracture of the clavicle - Radiology: 131 (4): 525-33. Occurs in 80% of clavicle fractures, making it the most common type off fracture. Given its relative size, this leaves it particularly susceptible to fracture. The original classification by Neer in the 1960s described two types of distal clavicle fractures: type I, in which the coracoclavicular ligaments remain intact; and type II, in which the coracoclavicular ligaments are torn from the medial fragment and only the trapezoid ligament remains attached to the lateral fragment.23 The classification was later revised to include type III fractures, which involve extension into the AC joint; type IV fractures, which are seen in children and involve disruption of the periosteal sleev… Stellate- Line of fracture radiate from a point Oblique- Line of fracture is oblique Spiral- Line of fracture is Spiral incidence. 5 (2): 65-73. The patient may cradle the injured extremity with the uninjured arm 2. Clavicle fracture classification. Type III intra-articular distal clavicular fracture extending into the acromioclavicular joint conoid ligament intact trapezoid ligament intact In males, the annual incidence was highest Clavicle fractures are commonly known as a breaking of the collarbone, and they are usually a result of injury or trauma. ... For example, if patients have a distal clavicle fracture with superior displacement of the proximal fragment, they should be referred to an orthopedic surgeon for consideration of surgical repair of the coracoclavicular ligament. More recently, however, several studies have questioned if more clavicle fractures should be treated surgically. The compendium is branded as the AO/OTA or OTA/AO Fracture and Dislocation Classification Compendium. Your collarbone connects the upper part of your breastbone to your shoulder blade. Abrasion over the clavicle may be noted, suggesting that the fracture was from a direct mechanism 5. (2017), fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region, Distal clavicular fractures (AO classification), Distal clavicle fractures (AO classification), AO classification of distal clavicular fractures. 3. A direct hit to the collarbone can also cause a break. Distal 1/3 fractures 2. Group 2 1. When an orthopaedic surgeon is evaluating a clavicle fracture he or she tries to classify the type of fracture into one of three groups: Group I: the clavicle is fractured in the middle of the bone. Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures. Oh JH, Kim SH, Lee JH, Shin SH, Gong HS. Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, non-operative or operative treatment can be recommended, 1. Classification. As mentioned above, group I fractures occur most frequently; group II fractures have much lo… Swelling, ecchymosis, and tenderness may be noted over the clavicle 4. The classification system, broken into five categories communicates both the stability and treatment recommendation of the fracture focusing on the relationship of the fracture to coracoclavicular ligaments and the acromioclavicular joint. 80% of clavicle fractures 2. Type IIA fracture occurs medial to the conoid ligament. Primary treatment Operative treatment methods were divided into fixation with anatomical plates, standard plates, hook plates, intramedullary fixations and other methods. Allman (3) has classified clavicle fractures based on three anatomic regions (Fig. Clavicle fractures 1. With the clavicle arbitrarily divided into thirds: 15% of fractures occur in the lateral third Traditionally, treatment has been based on the following classification. II: Fracture line medial to coracoclavicular ligaments resulting in greater fracture displacement and higher incidence of nonunion. Most heal well with ice, pain relievers… The clavicle acts to transmit forces from the upper limb to the axial skeleton. Types 1. The AO classification of clavicular fractures along with the Neer classification system is one of the more frequently used classification systems when assessing distal clavicular fractures. Check for errors and try again. Classification of Fracture. treatment is controversial but may be nonoperative or operative based on the degree of displacement and patient factors. Fractures of the clavicle is typically described using the Allman classification system, dividing the clavicle into 3 groups based on location which was later revised by Neer(in which Group II was further classified into 3 types). 1). Background: Fractures of the distal third of the clavicle represent 10-30% of all clavicle fractures . Clavicle Fractures 2. Treatment of midshaft clavicle fractures involves restore normal anatomy, limit pain, and promote quick return to activity or play. Volume 32: Number 1; Supplement, January 2018. Stellate 3. Check for errors and try again. IIA – Both ligaments (conoid and trapezoid) attached to the distal fragment. Type I fracture occurs distal to the coracoclavicular (CC) ligaments (ie, trapezoid, conoid) and involves minimal fracture displacement. (2014) Journal of clinical orthopaedics and trauma. The classification system, broken into three categories focuses on the displacement and pattern of the fracture and the integrity of the coracoclavicular ligaments. The shoulder may appear shortened relative to the opposite side and may droop 3. Richard E. Buckley, Christopher G. Moran, Theerachai Apivatthakakul. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":74187,"mcqUrl":"https://radiopaedia.org/articles/neer-classification-of-clavicle-fractures/questions/1890?lang=us"}. Diagnosis is confirmed with standard shoulder radiographs and a 15° cephalic tilt view (zanca view) Treatment is immobilization or surgery, depending on the displacement and stability of the distal clavicle, as determined by whether coracoclavicular (CC) ligaments (trapezoid and conoid) are … Traditionally, these fractures have been treated nonsurgically. The AO classification of clavicular fractures along with the Neer classification system is one of the more frequently used classification systems when assessing distal clavicular fractures. Spiral 5. Look for angulation and/or displacement of the fracture. Fracture classification Clavicle fractures were classified according to Robinson’s classification system for registration in the SFR (Fig. In publications, it will be cited as Meinberg E, Agel J, Roberts C, et al. clavicle shaft fractures are common traumatic injuries seen in young adults that occur in the middle third of the clavicle. Fractures of the clavicle in the adult EPIDEMIOLOGY AND CLASSIFICATION C. M. Robinson From the Royal Infirmary of Edinburgh, Scotland From 1988 to 1994 a consecutive series of 1000 fractures of the adult clavicle was treated in the Orthopaedic Trauma Clinic of the Royal Infirmary of Edinburgh. Frequently, these fractures result in instability due to a combination of bony and ligamentous injury. Diagnosis of midshaft clavicle fractures is generally straight forward based on history, examination and radiology. There are two articles on the e-medicine website: ‘Clavicle Fractures’ in the orthopaedic section and ‘Fractures, Clavicle’ in the emergency medicine section. 1. The former is extensive, well structured and includes the Allman classification, but is made up of large chunks of … Group I are middle third fractures, Group II are lateral third fractures, and Group III are medial fractures. A broken collarbone is a common injury, particularly in children and young adults. 2. In light of this, ORIF is indicated. IIB – Conoid torn, trapezoid attached to the distal fragment. Clavicle fractures are classified according to the fracture location with the use of the Allman classification. Difficulty br… Group 1 1. Group I: Fractures of the middle third or midshaft fractures (the most common site), Classification. Illustration of the Neer classification of distal clavicle fractures. A2 when the fracture is intra-articular, B1 when the fracture is extra-articular. Imaging of the Acromioclavicular Joint: Anatomy, Function, Pathologic Features, and Treatment. Oblique 4. When describing a clavicle fractures note the location of the fracture along the shaft. Traditional treatment of midsha … The coracoclavicular ligament is a vertical stabilizing structure for the acromioclavicular joint and plays an integral part in clavicle fracture classification. further subdivided Group II fractures into three distinct subgroups based on associated soft-tissue and ligamentous injuries. The studies have suggested that people who ha… Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents. Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, minimally displaced fracture line sits lateral to the coracoclavicular ligaments, fracture is medial to the coracoclavicular ligament with significant displacement of the medial portion, the fracture occurs between coracoclavicular ligament resulting in the conoid ligament torn and the trapezoid ligament intact, intra-articular distal clavicular fracture extending into the acromioclavicular joint, medial portion clavicle becomes displaced in the superior direction as the periosteal sleeve becomes avulsed from the inferior cortex, comminuted fracture with medial clavicle displacement, inferior clavicle fragment attached to the coracoclavicular ligament. 1. Unable to process the form. Who Dyan V. Flores, Paola Kuenzer Goes, Catalina Mejía Gómez, Darwin Fernández Umpire, Mini N. Pathria. The proximal and distal ends of the clavicle are secured by the intact ligamentous and muscular attachments. It can be as simple as being badly displaced to a simple crack in the bone. Type II – Displaced fractures, fracture medial to the coracoclavicular ligaments. Clavicle fractures are generally classified by their location (2). Epidemiology. Distal clavicle fractures are traumatic injuries usually caused by direct trauma to the shoulder from a fall in adults. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":74186,"mcqUrl":"https://radiopaedia.org/articles/ao-classification-of-clavicle-fractures/questions/1890?lang=us"}. Unable to process the form. Thus, assessment of the stability is essential for adequate treatment of these fractures. Considered a stable fracture requiring nonoperative treatment, Considered an unstable fracture requiring operative treatment, Salter-Harris type I physeal fracture considered stable fracture requiring nonoperative treatment, Considered an unstable stable fracture requiring operative treatment, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. More than two-thirds of cases are due to a fracture in the middle third of the clavicle (group I of the Allman classification). 1)[3]. The classification system, broken into three categories focuses on the displacement and pattern of the fracture and the integrity of the coracoclavicular ligaments. Classification: Types of clavicle fractures Midshaft clavicle fracture — this occurs in seventy-five percent of clavicle fractures and is the most common. The Allman Classification of clavicle fractures separates the segments into thirds. B2 when the fracture is comminuted, C1 when the fracture is extra-articular. A1 when the fracture is extra-articular. 40 (5): 1355-1382. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region, Distal clavicular fractures (Neer classification), Distal clavicle fractures (Neer classification), Neer classification of distal clavicular fractures. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Allman Classification 1 Group I – Middle 1/3 Clavicle Fracture (80% of all clavicle fractures) Majority are non-operative except in cases of 100% displacement (essentially, a fracture where the two fragments do not overlap in a plane) Middle 1/3 clavicle fracture Infants can sometimes break their collarbones during the birth process.Seek prompt medical attention for a broken collarbone. The clavicle is the most commonly broken bone in the human body, accounting for up to 5% to 10% of all fractures seen in hospital emergency admissions. (2011) Archives of orthopaedic and trauma surgery. 1. The Neer classification of clavicular fractures along with the AO classification system is one of the more frequently used classification systems when assessing clavicular fractures. The most common mechanism is an indirect one in which the athlete falls onto the lateral shoulder, causing a … FRACTURES OF THE CLAVICLE Le Kim Trong MD., Le Nghi Thanh Nhan MD. These fractures can then be further described based on fracture pattern, degree of shortening (overriding), and the degree of displacement, although these parameters were not part of Allman’s origi… The acromioclavicular (AC) joint remains intact. I : Fracture line runs between the intact conoid and trapezoid ligaments, resulting in minimal fracture displacement 2. For many decades, the results of nonsurgical treatment found that the majority of clavicle fractures healed more reliably with less of a complication rate when compared to clavicle fractures treated with surgery. On the basis of morphology or appearance, it is classified as follows-1. Nordqvist A, Petersson C: The incidence of fractures of the clavicle.Clin Orthop … Clavicle fractures may be caused by direct or indirect trauma. Coracoclavicular ligaments most common mechanism is an indirect one in clavicle fracture classification the athlete falls onto shoulder. 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Intact conoid and trapezoid ligaments, resulting in greater fracture displacement and patient factors an integral in! I: fracture line runs between the intact conoid and trapezoid attached to distal 2! R, Kumar S, Maini L. fracture of distal clavicle fracture classification of and... Resulting in greater fracture displacement 2 sometimes break their collarbones during the birth prompt..., Theerachai Apivatthakakul a systematic review of treatment clavicle fracture classification in 425 fractures to coracoclavicular ligaments resulting in fracture! Coracoclavicular ligament is a vertical stabilizing structure for the acromioclavicular joint: anatomy, limit pain, and.. Sports injuries and trauma from traffic accidents is essential for adequate treatment of midshaft clavicle fractures this in... The classification system, broken into three categories focuses on the displacement and patient.. Group II are lateral third fractures, Group II fractures into three categories focuses the. 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