the body to close and is rarely visible radiographically before age 18 years old Therefore, special views (e.g., the cephalic tilt view) or advanced imaging with CT may be necessary for the identification of posteriorly displaced sternoclavicular fractures ( Fig 111.10 ) Radiologic examination in these cases aims to identify any orthopedic injury as well as potentially lethal complications of trauma to the mediastinal structures that lie posteriorly, including the aorta and trachea Initial imaging for suspected AC joint injury should allow for comparison of the joints either through a single anteroposterior view, which includes both AC joints, or separate radiographs of each AC joint to allow for comparison Sensitivity for detecting injuries is increased if the x-ray is taken with the arm in internal rotation; however, stress views are no longer recommended Most clavicle shaft fractures and nondisplaced fractures of the lateral end of the clavicle in children are treated with nonoperative management due to the ability of pediatric bones to remodel Treatment of shaft fractures typically involves immobilization in either a sling and swathe or a simple sling for weeks and gradual return to daily activities depending on age and risk of repeat trauma Return to contact sports should be delayed until solid bony union occurs (typically between two to four months) The figure-of-eight splint, an alternative method of immobilization, can be more uncomfortable and cumbersome and has not been demonstrated to have superior outcomes For newborns and toddlers, the child can be put into a long-sleeved shirt with the distal sleeve of the injured side pinned to the shoulder area of the shirt of the contralateral side