title: [Relative clavicle shortening in pediatric fractures: its importance when selecting conservative treatment].
abstract: BACKGROUND
  Clavicle fractures represent 2-15% of pediatric fractures. The literature suggests operating on patients over 9 years of age with major shortening or severe comminution in the fracture line. However, no one establishes shortening or angulation parameters for conservative treatment in children. In pediatric patients it is important to take into account relative shortening, that is, the one caused by a fracture when compared with the length of the healthy clavicle.
  
  
  OBJECTIVE
  To know the effect of relative clavicle shortening on movement in pediatric fractures treated conservatively.
  
  
  METHODS
  Retrospective, longitudinal, observational study. We radiographically measured the relative shortening of the fractured clavicle comparing it with the healthy side at the time of the fracture and after fracture healing. Shortening was expressed in percentages. The following views were used: comparative anteroposterior view of the shoulders and panoramic view of both shoulders. Patients were divided into 2 groups: under 9 years and 9-15 years of age.
  
  
  RESULTS
  We analyzed 94 fractures; 31 in females and 63 in males. No pseudoarthrosis or symptomatic malunion occurred. The prognosis was good regardless of the initial shortening percentage. Age and shortening are proportionally related with the rehabilitation period and the restoration of painless ranges of motion. The value ranges recorded for shortening were 9.5 to 28%.
  
  
  CONCLUSIONS
  The surgical indications for shortening resulting from pediatric clavicle fractures should be revised. We have observed good results despite major shortening and total displacement.
authors.forename: A
authors.initials: A
authors.lastname: Leal-Oliva
authors.forename: F G
authors.initials: FG
authors.lastname: Mora-Ríos
authors.forename: C
authors.initials: C
authors.lastname: Mejía-Rohenes
authors.forename: A
authors.initials: A
authors.lastname: López-Marmnolejo
authors.forename: M J
authors.initials: MJ
authors.lastname: Acevedo-Cabrera
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002968:Clavicle / Q000293:injuries / Q000473:pathology*; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors