Surgical Treatment of Adolescent Clavicle Fractures: Results and Complications.
No level 1 evidence is available to guide the surgical treatment of adolescent clavicle fractures. Adult literature is not applicable as adolescent mid-diaphyseal clavicle fractures do not develop nonunions, and only a small percentage (10% to 20%) are symptomatic from malunions. Current indications for operative fixation are: (1) completely displaced midshaft fracture with shortening of >2 cm; (2) superior displacement with skin tenting and/or an impending open fracture; (3) associated neurovascular injury; (4) open clavicular fracture; and (5) floating shoulder with a completely displaced clavicular fracture. Future large prospective randomized studies will need to be performed to accurately define which adolescent patients will "truly" benefit from surgical intervention.
Texas Scottish Rite Hospital for Children, Dallas, TX.
Amy L
AL
McIntosh
D000293:Adolescent; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D017759:Fractures, Malunited / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005597:Fractures, Open / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology