Clavicle fractures: Associated trauma and morbidity

Abstract

Background: Clavicle fractures are frequently associated with trauma to regions beyond the immediate zone of injury. In order to provide surgeons with information on injury prevalence to prevent delays in diagnosis and management, we describe the epidemiology of concomitant injuries in patients with clavicle fractures and identify differences between those with open and closed fractures. Methods: The Nationwide Inpatient Sample (NIS) 2001e2013 database was queried for adult patients discharged with a diagnosis of a clavicle fracture using ICD-9 codes. A "common" injury was defined as prevalence 4.0% in our study population. We analyzed data for injury locations associated with open vs. closed clavicle fractures with chi square and independent samples t-tests. Results: A total of 41,1612 patients were included in our study population. The majority of patients had closed clavicle fractures (98.2%). The most common concomitant fracture was that of the rib, followed by the spine. The most common non-vascular, non-nervous injury was a hemo/pneumothorax followed by a lung, bronchus, or diaphragm injury. Fractures of the humerus, rib, scapula, pelvis, tibia or fibula, and facial bones as well as concussion, pneumo/hemothorax, other pulmonary, and splenic injuries were more common in patients with open clavicle fractures. Patients with open clavicle fractures were, on average, 11.8 years younger than those with closed fractures. Conclusion:There is a significant association between clavicle fractures and concussion, splenic, and thoracic injuries, as well as increased rate of complications with open fractures. Clinicians may use this information to perform risk assessments prevent delays in diagnosis.

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“…Changes in the overall distribution of fracture site in the superior limb were not observed except for clavicle fracture incidence that was significantly higher in 2020 (9.6% vs. 4.7%). This is probably due to the higher incidence of domestic traumas during the lockdown, as clavicle fractures usually occur after a fall from a bed or sofa [ 22 ]. Concerning the lower limb, the most involved site was the tibia, while in 2019 it was the metatarsals.…”

A Thoracic Outlet Syndrome That Concealed a Glioblastoma. Findings from a Case Report

“…Among these, as in the present case, falls and traumas such as cervical whiplash and fractures of the clavicle [ 33 ], or maintained stressful positions of the shoulder range of motion [ 34 ] have been reported to be risk factors of TOS. Unfortunately, these events are very common [ 35 , 36 ], and there is no direct causal association with TOS [ 37 ], so this could explain the poor awareness among doctors and healthcare professionals toward TOS and a substantial lack of consensus in diagnosis that makes it difficult to assess between physiologic brachial plexus compression and the true syndrome [ 18 ], as endorsed by the vague epidemiological available data on this condition [ 9 ]. Furthermore, the poor diagnostic accuracy of clinical tests for TOS [ 38 ], and its broad localization and features of symptoms, both vascular and neurogenic are very similar to other musculoskeletal, neurological and visceral disorders [ 12 , 39 ].…”

Management of Displaced Midshaft Clavicle Fractures with Figure-of-Eight Bandage: The Impact of Residual Shortening on Shoulder Function

“…Other rare but potentially serious complications could involve the chest, such as the pneumothorax or hemothorax, which can be excluded with both thorough clinical and radiographic assessments [ 4 , 33 , 34 , 35 , 36 , 37 , 38 ].…”