Elsevier

Journal of Shoulder and Elbow Surgery

Volume 11, Issue 5, September–October 2002, Pages 452-456
Journal of Shoulder and Elbow Surgery

Original article
Epidemiology of clavicle fractures*

https://doi.org/10.1067/mse.2002.126613Get rights and content

Abstract

An epidemiologic study of 535 isolated clavicle fractures treated in a hospital of a large metropolis during an 11-year period was performed. Data regarding patient's age and sex, side involved, mechanism of injury, and season in which the fracture occurred were obtained from the clinical records. Radiographic classification was performed with the Allman system. Clavicle fractures represented 2.6% of all fractures and 44% of those in the shoulder girdle. Most patients were men (68%), and the left side was involved in 61% of cases. Fractures of the middle third of the clavicle, which were the most common (81%), were displaced in 48% of cases and comminuted in 19%. Fractures of the medial third were the least common (2%). The prevalence of midclavicular fractures was found to decrease progressively with age, starting from the first decade of life when they represented 88.2% of all clavicle fractures and were undisplaced in 55.5% of cases. In adults, the incidence of displaced fractures, independent of location, was higher than that of undisplaced fractures. Traffic accidents were the most common cause of the injury. In the period under study, the incidence of fractures showed no significant change over time and no seasonal variation. (J Shoulder Elbow Surg 2002;11:452-6)

Section snippets

Material and methods

We examined the clinical records and radiographs of all patients who were treated at our hospital for a clavicle fracture between January 1990 and March 2001. To calculate the proportion of clavicle injuries with respect to all fractures in the shoulder girdle, fractures of the proximal humerus and scapula occurring in the same period were also recorded. Excluded from the study were all clavicle fractures associated with acromioclavicular or sternoclavicular dislocation or with other fractures

Results

Of 20,501 patients treated at our hospital for a fracture in the time interval under study, 533 (2.6%) had a clavicle fracture. Isolated clavicle fractures represented 44.1% of all fractures in the shoulder girdle. There were 362 men (67.9%), 2 of whom had a bilateral fracture, and 171 women (32.1%). The left side was involved in 60.7% of cases (P <.005).

The fractures were classified as group I in 435 cases (81.3%), group II in 89 cases (16.6%), and group III in 11 cases (2.1%). In group I the

Discussion

In previous reports providing epidemiologic data on clavicle fractures, no mention is made of whether the fractures scrutinized were isolated or associated with other fractures in the shoulder girdle. We limited our study to isolated fractures because they represent, from the etiopathogenetic and anatomic viewpoint, a homogeneous group of injuries.

In several studies,7, 9, 11, 15 which scrutinized a limited number of clavicle fractures, they represented 5% to 15% of all fractures. The incidence

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Reprint requests: Stefano Gumina, via Tacito 74, 00193 Rome, Italy (E-mail: [email protected]).

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