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Operative Treatment of Completely Displaced Clavicle Shaft Fractures in Children

Mehlman, Charles T. DO, MPH*; Yihua, Ge MD; Bochang, Chen MD; Zhigang, Wang MD

Journal of Pediatric Orthopaedics: December 2009 - Volume 29 - Issue 8 - p 851-855
doi: 10.1097/BPO.0b013e3181c29c9c
Trauma

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).

*Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH

Department of Pediatric Orthopaedic Surgery

Shanghai Children's Medical Center, Medical School of Shanghai Jiatong University, Shanghai, China

Study Conducted at Shanghai Children's Medical Center, Medical School of Shanghai Jiatong University, Shanghai, China.

Reprints: Charles T. Mehlman, DO, MPH, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH. E-mail: Charles.Mehlman@cchmc.org

© 2009 Lippincott Williams & Wilkins, Inc.