title: Open clavicle fractures and associated injuries.
abstract: OBJECTIVE
  To describe the associated injuries, demographic distribution, and management of patients sustaining open clavicle fractures.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  A single level-1 trauma center.
  
  
  METHODS
  Twenty patients with open clavicle fractures were identified from a prospectively collected orthopaedic trauma registry.
  
  
  METHODS
  All patients were managed with surgical irrigation and debridement with or without internal fixation.
  
  
  RESULTS
  Thirteen patients (65%) had a closed head injury. Fifteen patients (75%) had a significant associated pulmonary injury. In that group, there were 10 patients who had a pneumothorax (7 bilateral). Additionally, 12 patients had rib fractures and 11 had documented pulmonary contusions or effusions. Seven patients (35%) had a cervical or thoracic spine fracture or dislocation. Eight patients (40%) had concomitant scapula fractures. Six patients (30%) had additional ipsilateral upper extremity injuries remote from the shoulder girdle. One patient had a scapulothoracic dissociation. Eleven patients (55%) sustained significant facial trauma including fractures (5 patients), lacerations, and hematomas. Fourteen patients (70%) were treated with open reduction internal fixation. Fifteen patients (75%) were followed to healing (mean: 111 wk, median: 56 wk, range: 13 to 333 wk). There were no other complications related to the operative fixations. There were no known infections or nonunions.
  
  
  CONCLUSIONS
  Open clavicle fractures are a rare injury. Patients often have associated pulmonary and cranial injuries. Ipsilateral upper extremity and shoulder girdle injuries are common, whereas concomitant neurologic and vascular injuries are infrequent. The majority of patients have rapid and uneventful healing of their fractures after surgical treatment.
authors.affiliation: Department of Orthopaedics, Box 359798, 325 9th Avenue, Seattle, WA 98104, USA. ltaitsman@u.washington.edu
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Taitsman
authors.forename: Sean E
authors.initials: SE
authors.lastname: Nork
authors.forename: Chad P
authors.initials: CP
authors.lastname: Coles
authors.forename: David P
authors.initials: DP
authors.lastname: Barei
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002968:Clavicle / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005597:Fractures, Open / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome