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Clavicle Fracture Classification

 Allman Classification of clavicle shaft fracture

Allman Classification (Allman FL, JBJS 49A;774:1967)

 

 

Type I Clavicle shaft fracture xray

Group I - Middle 1/3 Clavicle Fracture

  • 69%-85% of clavicle fractures.
  • 0.13%-13% non-op nonunion rate overall
  • Generally treated non-oeratively
  • No difference between sling and figure-8 (Stanly, Injury 19;162:1988)
  • Closed reduction not helpful (Hill, JBJS 79B;537:1997)
  • 31% of non-op patients report shoulder weakness, fatigue, paresthesias and asymmetry.
  • Shortening >18 mm in males or >14 mm in females is associated unsatisfactory result. (Lazarides S, JSES 2006;15:191)
  • Operative indications=open fx, NVI, displaced fx with impending skin compromise, shortening >20mm, significant comminution, scapulothoracic dissociation.  Consider for neurologic disorders, floating shoulder, bilateral fx, cosmesis, ipsiliateral UE fx.
  • See Clavicle Fx ORIF Technique.
Distal clavicle fracture classification

Group II - Lateral Clavicle Fracture

Medial clavicle fracture xray

Group III-Medial Clavicle Fracture

  • Fracture in the medial 1/3 of clavicle
  • 3%-6% of clavicle fractures