This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 64-year-old woman who fell out of bed while sleeping and landed directly on the lateral aspect of the right shoulder. Based on the image shown here and a Zanca view radiograph, she was diagnosed in the emergency room with a lateral clavicle fracture. After staying in a sling for about two weeks, the patient continued to have shoulder pain when using the arm with overhead activities and when sleeping on the shoulder at night.
Select from among four choices as the next best step in treatment: MRI to evaluate the coracoclavicular ligaments, open reduction/internal fixation, continued sling treatment until pain resolves, or transacromial wire fixation.
7 thoughts on “JBJS JOPA Image Quiz: Lateral Clavicle Fracture”
Continued sling treatment
MRI to evaluate the coracoclavicular ligaments
MRI TO EVALUATE THE LIGAMENTS
Open reduction & internal fixation
I would prefer to continue sling treatment for four more weeks.
Si opta por tratamiento incruento seguirá con dolor y limitación en tareas por arriba de los 90 grados de elevacion durante 30 días más.
RAFI reducción anatómica y pronta función con restricciones hasta la consolidación 45 días?