Surgery Not Necessarily a Better Treatment for Clavicle Fractures

Pediatric patients experienced satisfactory results after undergoing either surgical or nonsurgical treatment of displaced clavicle fractures, according to recent study results.

Researchers with the Mayo Clinic reviewed the medical records and radiographs of 149 patients between the ages of 14 years and 17 years treated for 153 clavicle fractures to determine injury mechanism, fracture pattern, treatment and complications. The researchers also assessed injury severity as high, medium or low.

Results showed 15 percent of clavicle fractures were treated surgically, and fractures treated surgically were found to have greater shortening and were more likely to be comminuted compared with fractures treated nonsurgically.

Complications, including refracture, implant removal for prominence and nonunion with implant failure, occurred in 21.7 percent of fractures treated surgically, of which one was associated with intramedullary nailing and four occurred in clavicles treated with plate fixation, according to study results.

No patients who required delayed surgical intervention in the nonsurgical group sustained a refracture or malunion. Seventy-eight displaced fractures were treated by pediatric fellowship-trained orthopedic surgeons, resulting in 10.3 percent of surgeries, and 46 displaced fractures were treated by nonpediatric orthopedic specialists, resulting in 32.6 percent surgeries, the data showed.