Article Text

Download PDFPDF
G29(P) The management of children diagnosed with an uncomplicated clavicle fracture: broad-arm sling and written self-care information versus broad-arm sling and hospital outpatient follow-up
  1. RA Crowder,
  2. AG Rowland,
  3. S Tan,
  4. M Handford,
  5. MJ Stuart
  1. Emergency Department, North Manchester General Hospital, The Pennine Acute Hospitals NHS Trust, Manchester, UK


Background and objectives In July 2013 the Paediatric Emergency Department (ED) of a UK District General Hospital seeing approximately 30000 children per year aged under 16 years in the ED, began managing children diagnosed with an uncomplicated (no skin compromise and no clinical neuro-vascular deficit) clavicle fracture with a broad-arm sling and written self-care information, rather than a broad-arm sling and hospital-based fracture clinic follow-up. All other children continued to be referred to the fracture clinic. This study assessed the impact of this change in practice.

Methods A 15 month retrospective review of all children diagnosed with a clavicle fracture was conducted. Referrals to fracture clinic and the number of children re-attending the ED with complications related to the initial injury (for example pain or sling problem) were analysed. All children had a broad-arm sling applied.

Results 91 children were diagnosed with a clavicle fracture, 59 (median 5/month) pre-change in practice and 32 (median 7/month) post-change.

64 (70%) were referred to the fracture clinic, (52 (88%) pre-change in practice and 12 (38%) post-change). The remainder were discharged with written self-care information.

In the one month following initial attendance, 3 (5%) re-attended the ED pre-change in practice and 0 (0%) post-change.

Conclusions Children with an uncomplicated clavicle fracture can be appropriately managed with a broad-arm sling and written self-care information, rather than by hospital fracture clinic follow-up. This more efficiently uses healthcare resources, reduces re-attendances during the month following initial injury and reduces social inconvenience for children and families.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.