# An unusual presentation of a depressed clavicle fracture in a child leading to venous congestion

## TL;DR

A 12-year-old boy with a rare depressed clavicle fracture and a cervical rib was treated without surgery and recovered well.

## Contribution

First report of a depressed clavicle fracture associated with an ipsilateral cervical rib in a child.

## Key findings

- Conservative management with a sling led to recovery despite venous congestion concerns.
- The patient experienced a re-fracture 4 weeks later but still had a good clinical outcome.
- This case shows that non-surgical treatment can be effective for such rare injuries.

## Abstract

Clavicle fractures are common in children, comprising up to 15% of fractures presenting to the emergency department. Typically, mid-shaft clavicle fracture in the paediatric population is managed conservatively, with surgery recommended in a select few. A 12-year-old boy presented with a depressed mid-shaft clavicle fracture with an ipsilateral cervical rib exhibiting features of venous congestion. This case was managed conservatively using a sling and the patient was admitted for overnight observation with early mobilisation encouraged. His recovery was complicated by a re-fracture 4 weeks later, which was managed conservatively with a good clinical outcome. This is the first report of such a fracture associated with an ipsilateral cervical rib. This case highlights that such injuries with vascular concerns could be managed conservatively with good outcomes.