Clavicle, Lower Arm and Scaphoid Fractures

Fracture of the clavicle is one of the most common fractures seen in sporting activities. It is usually caused by either a fall onto the point of the shoulder, for example by direct contact with opponents in sports such as rugby.

Presentation

  • Severe tenderness and swelling over the area of fracture.
  • Pain when moving the shoulder.
  • Crackles (crepitus) felt between bone ends when movement is attempted.

Management

  • Provide adequate pain relief
  • Figure-of-eight bandage to immobilise both shoulders applied by a health professional
  • Most clavicle fractures will heal within 4-6 weeks
  • Conditioning exercises such as running should not be resumed until the fracture has healed or does not cause pain

Fracture of the Distal Radius

Distal radius (forearm) fractures are very common. As the force required to fracture young adults’ bones is great, players may also have a ligament strain or rupture.

 

Fracture of the Scaphoid

Presentation

  • Wrist pain
  • Swelling
  • Loss of grip strength
  • Tenderness between the thumb and finger.

Diagnosis

  • Plain x-rays with special scaphoid views usually demonstrate the fracture
  • If a scaphoid fracture is suspected clinically but the X-ray is normal, a fracture cannot be ruled out
  • MRI is the ideal test and is increasingly used

Management

  • Most scaphoid fractures are immobilised with a plaster cast
  • Displaced fractures may require surgery
  • Athletes are advised to wear a protective splint for two months after the fracture has healed.