Overview
A stress fracture of the clavicle is a fatigue injury to the bone, often occurring in athletes or individuals with repetitive overhead activities. The clavicle's nutrient foramen, a potential site for vascular compromise, is present in nearly all individuals and is typically located on the posterior surface of the middle third 1.Diagnosis
Diagnosis is typically based on clinical suspicion and confirmed with imaging.
Radiographs may show subtle findings or be normal initially.
CT or MRI can better delineate stress fractures and rule out other pathologies 1.Management
Management is generally conservative, focusing on rest and activity modification.
Pain management may include analgesics.
Sling immobilization may be used for comfort.
Surgical intervention is rarely indicated and reserved for cases with significant displacement or nonunion.Key Recommendations
The nutrient foramen is present in 97.75% of clavicles and is usually a single foramen on the posterior surface of the middle third 1.
Understanding the location of the nutrient foramen may aid in interpreting fractures and avoiding iatrogenic injury 1.
Conservative management including rest and pain control is the mainstay of treatment for clavicular stress fractures 1.References
1 Ejlersen M. The human clavicle's nutrient foramen's prevalence, number, location, and direction: A systematic review and meta-analysis. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2023. link