Physiotherapeutic approach to clavicle fracture with conservative management in older adults: a case report

Abstract

The clavicle is divided into three thirds: medial (proximal), middle (diaphysis), and lateral (distal). Fractures of the distal third of the clavicle account for 15% to 30% of all clavicle fractures. The complex anatomy of this area and external forces pose a higher risk of delayed consolidation and non-union compared to other parts of the clavicle. In this case report, a therapeutic proposal was justified for an elderly patient aged 82 with a distal clavicular fracture resulting from a fall at her own height. Despite factors such as age, comorbidities, and risks, a conservative management approach was chosen, even though current evidence and medical recommendations favored surgical intervention to stabilize the affected area and improve functional outcomes and pain. Treatments included stabilizing bandages, magneto therapy, high-intensity laser therapy, low-intensity laser therapy, electrical stimulation, and therapeutic exercises, along with a self-management plan and educational interventions. The patient received 24 physical therapy sessions, attending an average of 2 to 3 sessions per week, with the goal of enhancing physiological processes related to the injury and eventually achieving bone callus formation and subsequent consolidation. The outcome revealed that while bone consolidation was not achieved based on physical examination and medical imaging; the patient experienced complete pain relief and regained full functional range of motion. Additionally, a successful fall prevention plan was implemented. Conclusions: Conservative management of fractures in the distal third of the clavicle through physical therapy represents an effective strategy to mitigate pain, restore range of motion, and regain impaired functionality.