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מומלץ לגשת לדף של ה BMJ ![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%2082%2082'%3E%3C/svg%3E)
Case presentation ![](data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20118%2044'%3E%3C/svg%3E)
A right-hand dominant woman aged 46 years with a history of opiate use disorder presents to the ED following a right clavicle injury. While riding to work, the patient fell off her bicycle, landing on her right shoulder. She denies any other injury. On physical examination, she is tearful, cradling her right arm. Her vital signs are normal. Her right clavicle has an obvious deformity and associated bruising without overlying injury or tenting of the skin. She has severely reduced range of motion of the right shoulder due to pain but is neurovascularly intact distally. Plain radiography of her right clavicle (figure 1) revealed a comminuted right clavicular fracture with a coracoclavicular distance of 7 mm. Given her personal history with opioids, the patient declined narcotics but was in severe acute pain. Thus, the ultrasound machine was brought to the bedside in anticipation of ultrasound-guided regional anaesthesia of the superficial cervical plexus.