Clavicle fractures in head-injured children
1Department of Orthopaedics and Rehabilitation, Southern Illinois University School of Medicine, Springfield 62708.
Insights
Pediatric clavicle fractures from head trauma in children typically heal well without immobilization. Most children regain full shoulder range of motion, with few requiring surgical intervention.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Sports Medicine
Background:
- Clavicle fractures are common pediatric injuries, often resulting from falls or direct impact.
- Head trauma can lead to associated injuries, including fractures of the clavicle.
- Understanding the healing patterns and outcomes of pediatric clavicle fractures is crucial for effective management.
Purpose of the Study:
- To evaluate the incidence and outcomes of clavicle fractures in children treated for head trauma.
- To assess the healing process, remodeling potential, and functional recovery following clavicle fractures in this cohort.
- To identify any specific injury patterns, such as "double" clavicle, and their management implications.
Main Methods:
- Retrospective review of pediatric patients treated for head trauma between 1960 and 1985.
- Identification of patients with associated clavicle fractures.
- Analysis of fracture healing, complications, and functional outcomes, including range of motion and need for surgery.
Main Results:
- 35 out of 499 children (7%) with head trauma sustained 38 clavicle fractures.
- Two patients developed a "double" clavicle secondary to lateral physeal injuries.
- All clavicle fractures healed without immobilization, demonstrating excellent remodeling and full shoulder range of motion recovery. Only one patient required surgery for a bony prominence.
Conclusions:
- Pediatric clavicle fractures associated with head trauma generally exhibit favorable outcomes with non-operative management.
- Excellent remodeling and functional recovery are typical, even in cases with unique presentations like "double" clavicles.
- Conservative treatment is effective, with a low incidence of complications or need for surgical intervention in this patient group.
Abstract:
Between the years 1960 and 1985, 499 children were treated at Rancho Los Amigos Hospital for residuals of head trauma. Of these, 35 had fractures of the clavicle (38 total fractures). Two of the patients had lateral physeal injuries and subsequently developed a "double" clavicle. All of the clavicle fractures healed without immobilization and exhibited excellent remodeling. All patients recovered complete range of motion of the shoulder. Only one of the patients required surgery (for removal of a tender bony prominence after the formation of a "double" clavicle).
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