A school-age child suffers a closed fracture of the right clavicle after a fall from a swing. How is this managed?

• A. Figure-eight clavicle brace
• B. Hospitalization for traction
• C. Sling immobilization
• D. Refer the child to an orthopedic specialist for possible surgical reduction

Answer: (C)

In school-age children, a closed clavicle fracture is almost always managed nonoperatively because kids heal quickly and have good remodeling with simple immobilization. A sling provides adequate support and pain control while allowing basic arm movement, which helps maintain shoulder function and reduces stiffness. This approach avoids the discomfort and skin problems sometimes seen with a figure-eight brace and avoids hospitalization or surgery when there are no signs of complications. Surgery is reserved for cases with open fracture, neurovascular injury, skin tenting with risk to underlying structures, or failure of nonoperative treatment; in a straightforward closed fracture, those situations aren’t present, so sling immobilization is the best option.