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Operative Versus Nonoperative Treatment of Z-Type Clavicle Shaft Fractures in Adolescents: A Retrospective Study

Year: 2025

Type: article

Abstract: BACKGROUND: There are differing opinions in the literature regarding the optimal treatment modality for adolescents with completely displaced, complex clavicle fractures. This study aims to determine outcome differences between surgical and non-surgical treatment for adolescent Z-type clavicle fractures and to ascertain if differences exist in outcomes between the two interventions. METHODS: This was a single-center, retrospective chart review performed at a level 1 trauma center. Inclusion criteria included pediatric patients ages 12 to 16 years who presented with a comminuted, displaced clavicle shaft fracture with a comminuted fragment more than 1 cm in length and were treated either operatively or nonoperatively between January 2019 and December 2022. The outcomes were radiographic union status (i.e., union versus non-union versus malunion), follow-up period, shoulder range of motion, return to athletic activities, and patient reported pain level. RESULTS: = 0.0009). There was no significant difference between patient reported pain, radiographic union status, return to athletic activity, or shoulder range of motion between the cohorts. The small sample size and retrospective study design limits the statistical power of our results. CONCLUSIONS: The decision between treating these complex fractures operatively versus nonoperatively should be left to a lengthy discussion between the surgeon, parents, and the patient.

Source: Children

DOI: 10.3390/children12101278

Authors: Iulia Dobrin, Colin Van Wagoner, Sami Azeroual, Joseph Leider, Ehab Saleh

Institutions: Oakland University, Beaumont Health, Beaumont Hospital, Royal Oak

Language: English

Topic: Shoulder and Clavicle Injuries

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,896