A 19-year-old man falls off his bicycle onto his shoulder. X-ray shows a closed fracture of the clavicle. Which part of the clavicle is fractured most commonly, and what is the standard initial treatment for an undisplaced fracture at this site?
- A Lateral third, shoulder immobiliser
- B Medial third, figure-of-eight bandage
- C Middle third, arm sling with gentle mobilisation ✓
- D Middle third, immediate open reduction and plating
Correct answer: C. Middle third, arm sling with gentle mobilisation
Explanation
About 75 to 80 percent of clavicle fractures occur in the middle third, the junction between the two curvatures where the bone is thinnest and has no muscle attachment protection. Undisplaced middle-third fractures unite reliably with symptomatic treatment using an arm sling followed by pendulum exercises. Figure-of-eight bandaging offers no union advantage and causes more discomfort. Operative fixation is reserved for displaced fractures with skin tenting, shortening over 2 cm, floating shoulder, or open injury.
Reference: Apley's System of Orthopaedics and Fractures, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.