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Clavicle Fracture Malunion S42.009P 733.81

clavicle fracture malunion

clavicle anatomy picture

clavicle bony anatomy

Allman classification picture

 

 

 

 

 

 

 

synonyms: colar bone fracture

Clavicle Fracture Malunion ICD-10

  • S42.001P - Fracture of unspecified part of right clavicle, subsequent encounter for fracture with malunion
  • S42.002P - Fracture of unspecified part of left clavicle, subsequent encounter for fracture with malunion
  • S42.009P - Fracture of unspecified part of unspecified clavicle, subsequent encounter for fracture with malunion

Clavicle Fracture Malunion ICD-9

  • 733.81  Malunion of fracture

Clavicle Fracture Malunion Etiology / Epidemiology / Natural History

Clavicle Fracture Malunion Anatomy

  • S shaped: anterolateral surface is concave, convex on anteromedial surface.
  • First bone to ossify, 5th gestational week
  • Only long bone to ossify be intramembranous ossification
  • Medial physis=80% of longitudinal growth
  • Both acromial and sternal physes can remain open into 3rd decade of life
  • Middle 1/3 fractures typically heal with the lateral shaft fragment displaced posterior to the medial shaft fragment / anterior-posterior angulation. (Edleson JG, JSES 2003;12:173).
  • Diameter of medullary canal is approximately 7mm at its narrowest point. (Andermahr J, Clin Anat 2006;20:48).
  • See also Shoulder Anatomy.

Clavicle Fracture Malunion Clinical Evaluation

  • Patients complain of; shoulder weakness, fatigue, paresthesias, cosmetic deformity, pain at rest or with activity, asymmetry.
  • Pain over clavicle, crepitus.
  • Ptosis of affected shoulder.

Clavicle Fracture Malunion Xray / Diagnositc Tests

  • A/P view of clavicle and 30°-45º cephalic tilt view of clavicle.
  • Apical oblique (Grashe with 20 cephalad)
  • Abduction Lordotic (after ORIF)
  • Serendipity view (helps with A/P displacement)
  • Axillary
  • Zanca 15 degree apical oblique (AC joint)

Clavicle Fracture Malunion Classification / Treatment

  • Nonoperative: physical therapy, activity modifications, NSAIDs
  • Operative: osteotomy with Clavicle Fracture ORIF 23515 +/- bone grafting. 

Clavicle Fracture Malunion Associated Injuries / Differential Diagnosis

  • Clavicle fracture nonunion

Clavicle Fracture Malunion Complications

  • Infection
  • Neurovascular Injury
  • Hardware failure (Brouwer KM, JSES 2008 IP)
  • Sequelae of clavicle fractures: shoulder weakness, fatigue, paresthesias, cosmetic deformity, pain at rest or with activity, asymmetry.

Clavicle Fracture Malunion Follow-up Care

Clavicle Fracture Malunion Review References