Satisfactory results found through operative fixation of displaced midshaft clavicle fractures in skeletally immature patients

Namdari S, et al. J Pediatr Orthop. July/August 2011;31(5):507-511. doi: 10.1097/BPO.0b013e318220ba48

Operative fixation of displaced midshaft clavicle fractures in skeletally immature patients can produce satisfactory results, according to researchers in Philadelphia.

Surena Namdari, MD, MSc, and his fellow researchers also noted that operative patients could be prone to numbness at the site of incision and require further surgery for removal of prominent or painful hardware.

The team performed a retrospective review of 14 skeletally immature patients who sustained closed, displaced, midshaft clavicle fractures and received open reduction internal fixation. Demographic and radiographic indices were utilized for baseline data acquisition, with follow-up radiographic and functional outcomes assessment being performed through the Quick Disability of Arm, Shoulder, and Hand Questionnaire (QuickDASH), the simple shoulder test, and further binary questions.

Twelve of the 14 patients, the authors reported, underwent initial nonoperative treatment only to later undergo operative treatment as a result of increase displacement at the 3-week mark. With a 2-year minimum follow-up, Namdari’s team was able to report a mean postoperative total QuickDASH score of 7.0 and a mean of 11 affirmative responses to questions on the simple shoulder test.

The authors reported that four operative patients underwent a subsequent surgical procedure in the interest of removing hardware, with eight patients complaining of numbness at the surgery site. Healed fractures were reported in each case at the radiographic 3-month follow-up.