No evidence for either Collar and cuff or sling after fracture of the clavicle

Report By: Simon Carley - Clinical Fellow
Search checked by Kevin Mackway-Jones - Consultant
Institution: Manchester Royal Infirmary
Date Submitted: 1st March 2000
Date Completed: 30th June 2000
Last Modified: 9th December 2003
Status: Green (complete)

Three Part Question

In [young patients with simple clavicle fractures] is [collar and cuff better than broad arm sling] at [reducing pain and reducing time to recovery].

Clinical Scenario

A 23 year old male presents to the emergency department following a fall on the outstretched hand. X-rays reveal a mid clavicular fracture. You know that a figure of eight bandage is of no benefit but are unsure whether a sling or a collar and cuff is best.

Search Strategy

Medline 1966-12/98 using the OVID interface.
([exp immobilization OR exp bandages OR collar and cuff.mp OR broad arm sling$.mp] AND {[exp clavicle OR clavicle$.mp OR clavicular.mp] AND [exp fractures OR fracture$.mp]}) LIMIT to human AND english language.

Search Outcome

20 papers found none of which were relevant.

Comment(s)

There is no literature on the use of collar and cuff or sling in simple clavicular fracture.

Clinical Bottom Line

There is no evidence to determine whether collar and cuff is better than sling for management of simple clavicular fractures. Local advice should be followed and the comfort of the patient must be taken into account.