Clavicular Fractures in the Adolescent
Midhat Patel1, Benton E Heyworth2, Niloofar Dehghan3
1Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.
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Current evidence suggests that the majority of clavicular fractures in adolescents can and should be treated nonoperatively.
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Although rare, in certain patients or fracture patterns, nonoperative management may be associated with delayed healing, prolonged disability, and/or poor functional outcome requiring secondary reconstruction.
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When warranted, primary open reduction and internal fixation with plate and screw application has consistently good outcomes with a low complication rate, with the most common complication being implant-related symptoms requiring a secondary surgical procedure for implant removal.
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Prospective, comparative studies examining operative and nonoperative treatment, including measures of early return to function, injury burden, return to athletic activity, complication and reoperation rates, and shoulder-girdle-specific, long-term outcome measures are warranted to further elucidate which fractures may benefit from primary fixation.
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