Clavicular Fractures in the Adolescent

Current evidence suggests that the majority of clavicular fractures in adolescents can and should be treated nonoperatively. Although rare, in certain patients or fracture patterns, nonoperative management may be associated with delayed healing, prolonged disability, and/or poor functional outcome requiring secondary reconstruction. When warranted, primary open reduction and internal fixation with plate and screw application has consistently good outcomes with a low complication rate, with the most common complication being implant-related symptoms requiring a secondary surgical procedure for implant removal. Prospective, comparative studies examining operative and nonoperative treatment, including measures of early return to function, injury burden, return to athletic activity, complication and reoperation rates, and shoulder-girdle-specific, long-term outcome measures are warranted to further elucidate which fractures may benefit from primary fixation.

Automated summary

Current evidence suggests that most clavicular fractures in adolescents can be treated nonoperatively, but in some cases, surgical intervention may be necessary for better outcomes. Open reduction and internal fixation with plate and screw application has consistent good results, although complications related to implants may require additional surgery. Further studies are needed to compare operative and nonoperative treatments and determine which fractures would benefit from primary fixation.