Clavicular Fractures in the Adolescent

J Bone Joint Surg Am. 2023 May 3;105(9):713-723. doi: 10.2106/JBJS.22.01036. Epub 2023 Feb 8.

Abstract

➤: Current evidence suggests that the majority of clavicular fractures in adolescents can and should be treated nonoperatively.

➤: Although rare, in certain patients or fracture patterns, nonoperative management may be associated with delayed healing, prolonged disability, and/or poor functional outcome requiring secondary reconstruction.

➤: When warranted, primary open reduction and internal fixation with plate and screw application has consistently good outcomes with a low complication rate, with the most common complication being implant-related symptoms requiring a secondary surgical procedure for implant removal.

➤: Prospective, comparative studies examining operative and nonoperative treatment, including measures of early return to function, injury burden, return to athletic activity, complication and reoperation rates, and shoulder-girdle-specific, long-term outcome measures are warranted to further elucidate which fractures may benefit from primary fixation.

MeSH terms

  • Adolescent
  • Bone Plates
  • Clavicle / injuries
  • Clavicle / surgery
  • Fracture Fixation, Internal / methods
  • Fracture Healing*
  • Fractures, Bone* / surgery
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome