The use of immobilisation in clavicle fractures in children below the age of five

April 24, 2008

April 24, 2008

Dr Alison Robinson, ST3 Emergency Medicine (Manchester Royal Infirmary)

Dr Alison Robinson, Manchester Royal Infirmary

In [children under the age of five with a fractured clavicle] does [the use of collar and cuff] affect [outcome]?

A 3 year old boy presents to the Emergency Department not using his left arm after a fall. He has a bruise over his left clavicle and is clinically tender over this area. X-ray reveals a mid-clavicular fracture. From your experience in adult Emergency Departments you wish to put him in a collar and cuff, however this seems to distress him. You wonder if it is necessary to immobilise him at all.

Medline 1950 - April week 3 2008 using the OVID interface.

([child$.mp OR paed$.mp] AND [fracture.mp OR Broken.mp] AND [clavicle.mp OR collar bone.mp OR shoulder.mp] AND [treatment.mp or exp Therapeutics OR sling.mp OR "collar and cuff".mp]) Limit to English language and Humans.

122 papers were found none of which were relevant.

There is no literature on the treatment of simple clavicular fractures in children under the age of 5.

There is no evidence to determine whether immobilisation is best for clavicular fractures in this age group. Local advice should be followed and the comfort of the patient must be considered.