Functional Outcomes of Clavicular Fractures Fixation in Adolescent Children

Abstract

Background: Fractures of the clavicle are common in both adults and children. Recent studies in the treatment of adult fractures have indicated that improved outcomes are achieved after open reduction and internal fixation. The aim of this study was to conduct a retrospective study of the functional outcomes after open reduction and internal fixation of displaced clavicle fractures in adolescent children.

Material and Methods: We analysed a retrospective case series of 28 adolescent children who had displaced fractures of the clavicle which were treated with open reduction and internal fixation. The rate of healing, radiographic outcomes, functional outcomes, and complications were looked at.

Results: There were 28 children with an average age of 13.8 years (range 13-16 years) had their closed unilateral clavicle fractures treated with open reduction and internal fixation. All the patients were boys. The right side was affected in 14 patients and the left in 14. There were 26 mid-shaft fractures and two lateral-end fracture. Patients were followed for an average of 12 months. There were no superficial or deep infections and all cases went on to clinical and radiological union. Twenty-four (86%) of children returned to unrestricted sporting activity. The mean QuickDASH score at 12 months was 3.24. Four patients had scar sensitivity, and four had plate prominence. Ten patients required metalwork removal.

Conclusion: Historically, almost all clavicle fractures in children were treated non-operatively regardless of the displacement and the location of fractures, with variable outcomes. We conclude that open reduction and internal fixation of displaced clavicle shaft fractures in older children can be performed safely and gives predictable results especially with healing periods and functional outcomes.