Distal clavicle fractures in children

Abstract

ObjectiveTo analyze fractures of the distal clavicle region in pediatric patients.MethodsTen patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system.ResultsAll the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture.ConclusionThe treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments.

Health-related Quality of Life After Fractures of the Lateral Third of the Clavicle in Children and Adolescents

“…Although there are some other studies reporting clinical results, none of those used patient-reported outcome measures. 4,21 The rate of surgery with 1 case in 69 patients was low in our cohort. Other authors have reported comparable low rates of surgery in such patient groups.…”

“…Second, there is no universally accepted classification system for the radiologic assessment of these fractures, and we followed the definition that a lateral fracture of the clavicle is located in the distal third. 20 We have utilized the most recent system suggested by Nenopoulos et al 16,21 Although this is considered to be a modern system, 4 we were not able to sufficiently allocate every fracture within this system. This included transverse fractures located on the medial aspect of the lateral third, which appeared to represent a midshaft fracture of the clavicle, although the fracture localization was distal to the middle third.…”

“…Other authors have reported comparable low rates of surgery in such patient groups. 21,27 As other authors appear to have lowered the age threshold for performing surgery in children, we analyzed the effect of age at the time of injury. We could not demonstrate an association of the effect of age at the time of the injury in relation to the main outcome measure.…”

“…We also classified the fractures according to the system proposed by Nenopoulos et al, 16 for which a graphical representation is available. 21 The persons performing the image analysis were not aware of the patient's clinical result, thereby avoiding observer bias.…”

Functional Outcomes of Clavicular Fractures Fixation in Adolescent Children

“…Nine patients were treated conservatively and one surgically. They reported The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments [18] . This present study tracked the medium-term progress of clavicular fixation in a paediatric sample, however it is not without limitations.…”