Clavicle Fracture

History: child with left shoulder pain after bicycle accident. 

Clavicle Fracture – a fracture is seen at the mid left clavicle (yellow arrow) with mild apex cephalad angulation.

This is a typical clavicle fracture in children with mild apex cephalad (pointing upward towards the head) angulation. This clavicle fracture actually exhibits full thickness break through the bone cortex, but children can frequently have incomplete fractures. These are referred to as buckle fractures (or torus fractures, from the Latin word “tori” meaning protuberance or swelling), greenstick fractures, and plastic bowing fractures. Here is the difference:

Buckle fractures: angular deformity found at the site of compression impact, opposite side cortex of bone is intact.

Greenstick fractures: fracture of the cortex opposite the side of impact (the tension, convex side)

Plastic bowing fracture: bowing deformity without visible fracture lines. See one here.

Comminuted left clavicle fracture. (Photo credit: Wikipedia)