healing time for a lateral clavicular growth plate fracture (nondisplaced)

by Jack Freidel, M. D.
(Union, Ky)

A 16 y/o sustained a lateral clavicular growth plate fracture while playing school football 5 weeks ago. The fracture was diagnosed by MRI. There is no AC or tendon tears. The athlete still has slight pain at the fracture site, with decreased ability to move his arm backward in the passing position. The player is able to lift weights and run without pain. How long should this player remain out of contact practice and game play?

Comments for healing time for a lateral clavicular growth plate fracture (nondisplaced)

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Sep 04, 2008
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6 weeks, then gradual return with padding
by: Bart - SII

6 weeks is a general rule of thumb for fractures - with that said, I believe that restoring normal functional movement and strength before returning to full activities is essential for recovery and to prevent future injury.

For my patients, after 6 weeks, if there is minimal pain at the fracture site and with ADL's, I would consider a return to pain free non-contact activities (drills, passing activities, etc) as well as continuing with a comprehensive strengthening and motion program for the shoulder. Progress activities as tolerated into light contact/full contact over 1-2 weeks or as the athletes response dictates. Full unrestricted release would be based on full pain free functional range of motion, good strength, and no pain with activities.

I would also consider padding the AC / lateral clavicle area to avoid excessive stress to this area once full contact is resumed.

Bart

Sep 04, 2008
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Sources to purchase padding for the AC/lateral clavicular area during contact football
by: Jack Freidel, M.D.

Bart, thank you for your comment on the above. Parents are interested in finding a source to purchase quality padding to protect the AC/lateral clavicular area. The only padding that they have found is a vest type shock absorber, that doesn't seem to pad the clavicle area sufficiently. Do you know of any vendors that sell protective padding for this area and will allow sufficient upper extremity mobility and protection.

Sep 04, 2008
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Do they have an AT at the school?
by: Bart - SII

They may want to look at a Shoulder Injury Pad from Medco Supply.

They also make an impact pad that forms a hard shell relief area over the AC/Clavicle

I have always made a custom donut relief pad for my athletes with AC or clavicle injury, very similiar to the above impact pad. Depending on how severe the injury is, I either use foam and a hard shell, or foam alone. It takes the stress off of the injured site, and spreads the force from contact out and away from the injured tissue.

Using 1/2 inch foam, you create a circular pad that covers the injured area and extends 1-2 inches outward, and then cut out the center so that the pad surrounds the end of the clavicle / AC joint, creating a donut around the painful spot. This allows for the pad to absorb stress from hits, and protects the injured area. It can be taped on and then secured additionally with the undershirt and shoulder pads. 1/2 inch foam is cheap, and the pad can be re-used. If they have an athletic trainer at the school, this should be something they can fabricate easily.


Feb 27, 2010
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Further query re protection
by: Anonymous

You case sounds exactly that of my 16 year old. Injury is healing but not fully healed as yet. In addition, there is a spiky protrusion at the site of healing. Orthpod is reviweing again in 5 weeks and it is likely that surgery will be required to smooth out the protrusion. In the meantime will your donut suggestion be useful as protection in these circumstances?

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