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Pediatric Shoulder Injuries

Clavicle. Not just an accessory boneConnects thorax to shoulderSC, CC, AC Joint and ligamentsDeltoid, Trapezius, Pec MajorProtects Subclavian Vessels and Brachial Plexus. Clavicle. S shaped double curveMedial end fuses age 22-26Most common Birth Fx (.27-6%)>4000g 13% incidenceConcomitant

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Pediatric Shoulder Injuries

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    1. Pediatric Shoulder Injuries Joel Gonzales, M. D. Tuckahoe Orthopaedic Associates

    2. Clavicle Not just an accessory bone Connects thorax to shoulder SC, CC, AC Joint and ligaments Deltoid, Trapezius, Pec Major Protects Subclavian Vessels and Brachial Plexus

    3. Clavicle S shaped double curve Medial end fuses age 22-26 Most common Birth Fx (.27-6%) >4000g 13% incidence Concomitant Plexus Injuries Rare

    4. Clavicle Fxs Children usually from direct blow Middle third most common SCM pulls proximal, Pec pulls down Classification (Allman) Type I middle third Type II distal to CC ligaments Type III medial third

    5. Clavicle Fxs signs and symptoms Birth Fxs obvious on xray Assymetric Moro Reflex Baby only feeds from one breast U/S

    7. Clavicle Fx Treatment Birth Fx - no treatment Proper lifting Pin shirt sleeve to shirt if uncomfortable Absence of calcification in a neonate after 11 days - child abuse

    8. Clavicle Fx Treatment Figure of eight vs. sling Same outcome Check skin daily with figure 8 Operative - Open or skin tenting Suture repair

    9. Clavicle Fx

    10. Medial Clavicle Injuries Most commonly SH Fx Tremendous remodeling potential Anterior most common Posterior impingement on mediastinal structures

    11. Posterior SC Dislocation

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