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

Report By: Dr Alison Robinson - ST3 Emergency Medicine
Search checked by Dr Alison Robinson - ST3 Emergency Medicine
Institution: Manchester Royal Infirmary
Date Submitted: 24th April 2008
Last Modified: 24th April 2008
Status: Blue (submitted but not checked)

Three Part Question

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

Clinical Scenario

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.

Search Strategy

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.

Search Outcome

122 papers were found none of which were relevant.

Comment(s)

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

Clinical Bottom Line

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.