Clavicular fracture

[Felix Albers]

Hi folks,

Yesterday I had a patient, 15 years old, with a right distal clavicular fracture, after falling from his skateboard. Rather trivial actually. But he also had on the ipsilateral arm a slightly diminished radial pulse, a slower capillary filling and lower temperature on the hand. He was admitted, his fracture was immobilized with an "eight-bandage" (how is this called in english...) and the next morning any signs of suspected vascular injury were gone.

Is there a suspicion of subclavian injury? How would you evaluate this injury? Would you indicate primary clavicular osteosynthesis based on the vascular finding?

Cheers,

Felix.