Fractura de clavícula en el adulto

It is a break in the continuity of bone tissue at the level of the clavicle. From an epidemiological standpoint, it accounts for 2 to 10% of all fractures. It is estimated to affect 1 in 1,000 people per year. Two-thirds of those affected are male. The middle third is the most frequently affected (69%), followed by the distal third (28%) and the proximal third (3%). It exhibits a bimodal pattern in patients under 25 years of age and over 55 years of age. The anatomical reasons why clavicle fractures occur most frequently in the middle third are: it is the most superficial area; it is the center of the italicized S; the subclavicular groove is deepest in this area; there are no ligament insertions in this zone; it overrides the first rib; the nutrient foramen is located there; and it is the narrowest portion. The clavicle's functions include providing power and stability to the arm, facilitating range of motion, serving as a site for muscle attachment, protecting neurovascular structures, and contributing to respiratory and cosmetic function. The mechanism of injury can be indirect or direct, with indirect injury being the most frequent. Examples include falls onto the shoulder (87%), direct trauma (7%), and falls onto an outstretched hand (6%). It can also occur due to muscle contracture, as in the case of seizures. A positive diagnosis is based on the history of trauma described in the mechanism of injury, clinical manifestations, and complementary imaging studies. The most common associated injuries are rib fractures, brachial plexus injuries, and skin lesions. Differential diagnosis should include sternoclavicular and acromioclavicular dislocations, for which radiographic projections using specific techniques are very helpful. The most widely used classification is that described by Allman, which is divided into three groups. The treatment of this traumatic condition can be conservative or surgical, each with very specific indications. The most frequently reported complications are: pseudoarthrosis, malunion, discomfort related to the osteosynthesis material, neurovascular injury, infection, pneumothorax, and adhesive capsulitis.