Transclavicular Osseous Sutures for the Treatment of Displaced Distal Clavicular Fractures in Children

Schilcher, Jörg; Scheer, Johan; Adolfsson, Lars

doi:10.1097/bot.0000000000000527

Cited by 5 publications

(10 citation statements)

References 19 publications

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“…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.…”

Section: Discussionmentioning

confidence: 53%

“…For instance, one author has mentioned an age threshold for 8 years for specific fractures, 16 and another author has described a new surgical technique for these fractures in children. 4 At our institution, we have also noted an increasing number of referrals for surgery from external hospitals, orthopaedic surgeons, or family doctors.…”

Section: Discussionmentioning

confidence: 80%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…1 There is an ongoing controversy as to which of these fractures need surgery. [2][3][4] As there is hardly any literature with regard to these fractures in children, some surgeons base their treatment recommendations on the experiences gained in adults, 5 wherein the literature traditionally suggests surgery for lateral fractures of the clavicle, 6,7 especially if the fracture is considered unstable because of a loss of stabilization by the acromioclavicular (AC) and coracoclavicular ligaments, [7][8][9][10][11][12] owing to a high risk of nonunion or nonesthetic appearance because of callus formation. 7 This could explain why there is a trend in the literature to lower the age thresholds for considering surgery for these fractures.…”

mentioning

confidence: 99%

“…[13][14][15] One recent study recommended that children older than 8 years with displaced fractures of the lateral third could be treated surgically to have better cosmetic results, 16 and another publication described a new surgical technique for use in children. 4 Moreover, lateral clavicular fractures in children can mimic AC dislocations, 17,18 an injury that is commonly seen in adults, and wherein some authors also recommend surgery. 2,7,19 All these publications are probably the reason why we frequently see children and adolescents with lateral clavicular fractures, who are referred to us for surgical management.…”

mentioning

confidence: 99%

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

Liebs

Ryser²,

Kaiser³

et al. 2019

Journal of Pediatric Orthopaedics

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Introduction: The health-related quality of life after pediatric fractures of the lateral third of the clavicle is unknown. Given the trend in the literature toward surgical management of clavicular fractures in adults, we frequently receive referrals for surgical management of lateral clavicular fractures in children. Therefore, we examined (1) the health-related quality of life of patients who sustained a fracture of the lateral third of the clavicle in childhood and who were treated at a large regional pediatric trauma center, (2) if the health-related quality of life was associated with the age at the time of the injury, and (3) whether fracture and displacement patterns were associated with health-related qualify of life. Methods: This is a retrospective case series. We were able to identify 69 patients (21 girls and 48 boys) who sustained a fracture of the lateral third of the clavicle between the period spanning from January 2004 to June 2015. These patients were asked to fill in a questionnaire that included the Quick version of the Disability of Arm, Shoulder, and Hand (DASH) (primary outcome) and the Pediatric Quality of Life Inventory (Peds-QL). Until July 2017, we were able to get a response from 56 of these patients, resulting in a follow-up of 81%.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

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

Liebs

Ryser²,

Kaiser³

et al. 2019

Journal of Pediatric Orthopaedics

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Clavicular Refracture at the Site of Angular Malunion in Young Athletes

Furey

Zdero

McKee

2017

Journal of Orthopaedic Trauma

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Adolescent displaced lateral-end clavicle fractures are not comparable to the adult variant. Epidemiology, fracture patterns and outcome of non-operative management

2022

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Background The primary aim of this study was to determine the epidemiology of lateral-end clavicle fractures in adolescents. The secondary aim was to assess the outcome following non-operative management. Methods A retrospective review of all adolescent clavicle fractures over a 10-year period was undertaken. Fracture classification, demographics, management, and complications were analysed. Functional outcomes were undertaken with the Quick Disabilities of Arm, Shoulder and Hand and EuroQol five-dimension at mean 8.8 years post-injury. Results In total, 677 clavicle fractures were analysed, 8.7% were lateral-end fractures ( n = 59/677). The median age was 14.6 (range: 13–17) and 92% were male ( n = 54/59). The incidence was 0.17 per 100,000 per year. All displaced physeal fractures (Neer IV n = 14) were managed non-operatively and of the six followed-up, all united with good outcomes. The adult type displaced fracture (Neer II) occurred in fifteen fractures, five underwent operative fixation and ten were managed non-operatively with one subsequent nonunion ( n = 1/10). Those patients that underwent non-operative management (response n = 5/10, 50%) reported a median Quick Disabilities of Arm, Shoulder and Hand of 2.3 but approximately 40% reported cosmetic and outcome dissatisfaction at long-term follow-up. Conclusion Displaced Neer II lateral-end clavicle fractures are rare in the adolescent population. Although nonunion is rare, some dissatisfaction with cosmesis persists at long-term follow-up despite good functional outcomes with non-operative management.

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Transclavicular Osseous Sutures for the Treatment of Displaced Distal Clavicular Fractures in Children

Cited by 5 publications

References 19 publications

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

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

Clavicular Refracture at the Site of Angular Malunion in Young Athletes

Adolescent displaced lateral-end clavicle fractures are not comparable to the adult variant. Epidemiology, fracture patterns and outcome of non-operative management

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