Clavicle fractures - epidemiology, biomechanics of injury and treatment methods
DOI:
https://doi.org/10.12775/JEHS.2023.14.01.018Keywords
clavicle, fracture, neer classification, figure-of-eight, armsling, orthopaedicsAbstract
Introduction and purpose: The aim of this study is to to review and analyze scientific research on the topic of clavicle fractures, including epidemiology and comparison of the current conservative and surgical treatment options.
State of Knowledge: Due to its structure and function as a support for the upper limb, the clavicle is one of the most frequently fractured bones in the human body. Any significant force acting on the shoulder, such as direct trauma or a fall onto an outstretched hand, can result in high stress forces, leading to a clavicle fracture. Depending on the location of the fracture, muscles pull the bone fragments in their respective directions, which affects the treatment approach for each type of fracture.To facilitate the choice of treatment method, classifications such as the Neer classification and the Edinburgh classification have been developed. Various surgical techniques as well as conservative treatments have been employed in the management of clavicle fractures.
Conclusions: The epidemiology of clavicle fractures shows a higher incidence in young males, particularly related to sports activities. The majority of fractures occur in the middle third of the clavicle, with fractures in the distal and proximal thirds being less common. Understanding the ligamentous connections of the clavicle is crucial for understanding fracture patterns. There is no single preferred method of treatment, therefore both conservative and surgical methods are used in the therapeutic process depending on the fracture type. The functional outcome of various surgical techniques is similar.
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Canadian Orthopaedic Trauma Society Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures, The Journal of Bone & Joint Surgery: January 2007 - Volume 89 - Issue 1 - p 1-10
doi: 10.2106/JBJS.F.00020
Robinson, C. Michael BMedSci, FRCSEd(Orth)1; Court-Brown, Charles M. MD, FRCSEd(Orth)1; McQueen, Margaret M. MD, FRCSEd(Orth)1; Wakefield, Alison E. MSc, MCSP1 Estimating the Risk of Nonunion Following Nonoperative Treatment of a Clavicular Fracture, The Journal of Bone & Joint Surgery: July 2004 - Volume 86 - Issue 7 - p 1359-1365
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doi: 10.2106/JBJS.J.01364
Robinson, C.M. FRCSEd(Tr&Orth)1; Goudie, E.B. BMedSci(Hons), MRCSEd1; Murray, I.R. BMedSci(Hons), MRCSEd, Dip SEM2; Jenkins, P.J. FRCSEd(Tr&Orth)1; Ahktar, M.A. MRCSEd1; Read, E.O. BMedSci(Hons)1; Foster, C.J. MBChB1; Clark, K. BSc1; Brooksbank, A.J. FRCS(Tr&Orth)3; Arthur, A. FRCS(Tr&Orth)3; Crowther, M.A. FRCS(Tr&Orth)4; Packham, I. BMBS, BMedSci, FRCS(Tr&Orth)4; Chesser, T.J. FRCS(Tr&Orth)4 Open Reduction and Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures, The Journal of Bone & Joint Surgery: September 4, 2013 - Volume 95 - Issue 17 - p 1576-1584
doi: 10.2106/JBJS.L.00307
Woltz, Sarah MD1,a; Krijnen, Pieta PhD1; Schipper, Inger B. MD, PhD1 Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures, The Journal of Bone and Joint Surgery: June 21, 2017 - Volume 99 - Issue 12 - p 1051-1057
doi: 10.2106/JBJS.16.01068
Canadian Orthopaedic Trauma Society Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures, The Journal of Bone & Joint Surgery: January 2007 - Volume 89 - Issue 1 - p 1-10
doi: 10.2106/JBJS.F.00020
McKee, Robbin C.1; Whelan, Daniel B. MD, FRCS(C)1; Schemitsch, Emil H. MD, FRCS(C)1; McKee, Michael D. MD, FRCS(C)1 Operative Versus Nonoperative Care of Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Clinical Trials, The Journal of Bone & Joint Surgery: April 18, 2012 - Volume 94 - Issue 8 - p 675-684
doi: 10.2106/JBJS.J.01364
Melean PA, Zuniga A, Marsalli M, Fritis NA, Cook ER, Zilleruelo M, Alvarez C. Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population. J Shoulder Elbow Surg. 2015 Apr;24(4):587-92. doi: 10.1016/j.jse.2014.11.041. Epub 2015 Jan 22. PMID: 25619692.
McKee, Robbin C.1; Whelan, Daniel B. MD, FRCS(C)1; Schemitsch, Emil H. MD, FRCS(C)1; McKee, Michael D. MD, FRCS(C)1 Operative Versus Nonoperative Care of Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Clinical Trials, The Journal of Bone & Joint Surgery: April 18, 2012 - Volume 94 - Issue 8 - p 675-684
doi: 10.2106/JBJS.J.01364
Ahrens, Philip M. FRCS(Tr&Orth)1,a; Garlick, Nicholas I. FRCS(Tr&Orth)1; Barber, Julie PhD2; Tims, Emily M. MSc1; The Clavicle Trial Collaborative Group The Clavicle Trial, The Journal of Bone and Joint Surgery: August 16, 2017 - Volume 99 - Issue 16 - p 1345-1354
doi: 10.2106/JBJS.16.01112
McKee, Robbin C.1; Whelan, Daniel B. MD, FRCS(C)1; Schemitsch, Emil H. MD, FRCS(C)1; McKee, Michael D. MD, FRCS(C)1 Operative Versus Nonoperative Care of Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Clinical Trials, The Journal of Bone & Joint Surgery: April 18, 2012 - Volume 94 - Issue 8 - p 675-684
doi: 10.2106/JBJS.J.01364
Ahrens, Philip M. FRCS(Tr&Orth)1,a; Garlick, Nicholas I. FRCS(Tr&Orth)1; Barber, Julie PhD2; Tims, Emily M. MSc1; The Clavicle Trial Collaborative Group The Clavicle Trial, The Journal of Bone and Joint Surgery: August 16, 2017 - Volume 99 - Issue 16 - p 1345-1354
doi: 10.2106/JBJS.16.01112
Woltz, Sarah MD1,a; Krijnen, Pieta PhD1; Schipper, Inger B. MD, PhD1 Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures, The Journal of Bone and Joint Surgery: June 21, 2017 - Volume 99 - Issue 12 - p 1051-1057
doi: 10.2106/JBJS.16.01068
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Canadian Orthopaedic Trauma Society Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures, The Journal of Bone & Joint Surgery: January 2007 - Volume 89 - Issue 1 - p 1-10
doi: 10.2106/JBJS.F.00020
Melean PA, Zuniga A, Marsalli M, Fritis NA, Cook ER, Zilleruelo M, Alvarez C. Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population. J Shoulder Elbow Surg. 2015 Apr;24(4):587-92. doi: 10.1016/j.jse.2014.11.041. Epub 2015 Jan 22. PMID: 25619692.
Plate fixation versus intramedullary nailing of completely displaced midshaft fractures of the clavicle
Fuglesang H. F. S., Flugsrud G. B., Randsborg P. H., Oord P., Benth J. Š., and Utvåg S. E.
The Bone & Joint Journal 2017 99-B:8, 1095-1101
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Plate fixation versus intramedullary nailing of completely displaced midshaft fractures of the clavicle
Fuglesang H. F. S., Flugsrud G. B., Randsborg P. H., Oord P., Benth J. Š., and Utvåg S. E.
The Bone & Joint Journal 2017 99-B:8, 1095-1101
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