MANAGEMENT OF CLAVICLE FRACTURES IN ADOLESCENTS A Critical Analysis Review

The clavicle grows at a constant rate (8.4 mm per year) and achieves 80% of its length by 9 years of age in girls and 12 years of age in boys. There is no consensus with regard to the optimal treatment approach to midshaft clavicle fractures in adolescent patients. Complications from nonoperative treatment, including malunion and nonunion, are rare but are associated with increasing age in adolescent patients. In the absence of skin tenting, comminution, or marked displacement or shortening, simple closed midshaft clavicle fractures may be safely treated without radiographic follow-up and/or in the primary care setting. Reported rates of complications following operative management of clavicle fractures vary widely. The implant fixation construct is based on fracture and patient characteristics and is at the discretion of the treating surgeon; however, Kirschner wire fixation should be avoided because of an unacceptable rate and severity of complications.