Operative treatment of completely displaced clavicle shaft fractures in children
Charles T Mehlman1, Ge Yihua, Chen Bochang
1Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Charles.Mehlman@cchmc.org
Insights
Open reduction and internal fixation (ORIF) is a safe procedure for pediatric clavicle shaft fractures. Most children achieve excellent healing and return to sports without significant complications.
Area of Science:
- Pediatric Orthopedics
- Surgical Outcomes
- Fracture Management
Background:
- Clavicle shaft fractures are common in children.
- Adult studies suggest open reduction and internal fixation (ORIF) improves outcomes.
- Pediatric outcomes after ORIF for clavicle shaft fractures require further analysis.
Purpose of the Study:
- To analyze outcomes of ORIF for displaced clavicle shaft fractures in children.
- To evaluate healing rates, radiographic results, functional recovery, and complications.
- To determine the safety and efficacy of ORIF in pediatric patients.
Main Methods:
- Retrospective case series of 24 children with displaced clavicle shaft fractures treated with ORIF.
- Evaluation of healing, radiographic outcomes, functional status, and complications.
- Follow-up averaged 2 years and 2 months.
Main Results:
- All 24 fractures healed with no deep or superficial infections or nonunions.
- 87% of children returned to unrestricted sports activities.
- Minor complications included scar sensitivity (2 patients) and transient ulnar nerve neurapraxia (1 patient).
Conclusions:
- ORIF for displaced clavicle shaft fractures in children is a safe and effective treatment.
- The procedure leads to high rates of fracture healing and return to activity.
- Complication rates are low, supporting ORIF as a viable option.
Background:
Fractures of the shaft of the clavicle are common in both adults and children. Recent adult studies have indicated that improved outcomes are achieved after open reduction and internal fixation. The purpose of this study was to analyze outcomes after open reduction and internal fixation of displaced clavicle shaft fractures in children.
Methods:
We analyzed a retrospective case series of 24 children whose displaced clavicle shaft fractures were treated through open reduction and internal fixation. Special attention was paid to the rate of healing, radiographic outcomes, functional outcomes, and complications.
Results:
Twenty-four children with an average age of 12 years and 8 months (range 7 to 16 y) had their closed unilateral clavicle shaft fractures treated via open reduction and internal fixation. Patients were followed for an average of 2 years and 2 months. There were no deep or superficial infections and no nonunions. Eighty-seven percent (21 of 24) of children returned to unrestricted sports activities. Two patients suffered from scar sensitivity and 1 patient experienced a transient ulnar nerve neurapraxia secondary to their initial injury. All fractures healed and all orthopaedic implants were later electively removed.
Conclusions:
We conclude that open reduction and internal fixation of displaced clavicle shaft fractures in children can be performed safely.
Level Of Evidence:
Level 4, therapeutic study (retrospective case series).
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