Increase in surgical fixation of pediatric midshaft clavicle fractures since 2008

BMC Musculoskeletal Disorders

Elina Sassi¹  Juuli Hannonen¹  Willy Serlo¹  Juha-Jaakko Sinikumpu¹ 

[1] Department of Children and Adolescents, Oulu University Hospital, Oulu Childhood Fracture and Sports Injury Study, Medical Research Center Oulu, PEDEGO Research Group, University of Oulu;

关键词: Clavicle;    Fracture;    Children and adolescents;    Operative treatment;    Surgical fixation;   

DOI  :  10.1186/s12891-021-04918-x

来源: DOAJ

【 摘 要 】

Abstract Background Clavicle fractures in children have traditionally been treated non-operatively. In adults, a great increase in operative treatment has been reported. We aimed to analyze the respective trend and potential explanatory factors in children. Methods This is a single-institution retrospective study in a subregion in Northern Finland. The ICD-code S42.0 was used to identify the cases in the hospital registry. Altogether, 214 children, aged < 16, with consecutive clavicle fractures were first enrolled in the area during 2008–2019. Hospital journals and radiographs were reviewed. After lateral and medial fractures and patients living outside the area were excluded, final study population was 172. The respective population at risk was extracted by Statistics Finland. Predictive factors and annual rates of operative treatment as adjusted for 100,000 children at risk were determined. Results The rate of the surgical treatment of clavicle fractures increased from zero in 2008 to 10.8 in 2019 per 100,000 age-adjusted children (β = 0.864, 95% confidential intervals (CI) 0.4 to 1.4). There was a rise in the rate of surgery from 2.6% (2014–16) to 16.1% (2017–19) (diff. 13.5, 95% CI 1.7 to 23.3%). A displacement > 15 mm and a shortening of > 15 mm were associated with the increased risk of surgery but did not change during the study period. Age > 9 years increased the risk of surgery; the mean age increased from 5.5 years (2008–10) to 8.5 years (2017–19). There was a 3.6-fold increase in sports-related fractures (95% CI 7.4 to 26.4). The severity of the fractures did not change. Conclusions There has been an increasing trend in the surgical fixation of pediatric middle shaft clavicle fractures since 2008. The available literature does not support the trend.

【 授权许可】

Unknown