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. 2015 Mar;7(2):137-41.
doi: 10.1177/1941738114566381.

Surgical treatment of clavicle fractures in the adolescent athlete

Nathan J Fanter  1 , Ryan M Kenny  2 , Champ L Baker 3rd  3 , Champ L Baker Jr  3
Affiliations

Surgical treatment of clavicle fractures in the adolescent athlete

Nathan J Fanter et al. Sports Health. 2015 Mar.

Abstract

Context: Current literature has clearly shown that the indications for surgical treatment of clavicle fractures in adults are expanding. Although clavicle fractures in children and adolescents have traditionally been treated nonoperatively, surgical treatment of displaced clavicle fractures may be indicated for adolescent athletes.

Evidence acquisition: A review of relevant articles published between 1970 and 2013 was completed using MEDLINE and the terms clavicle fracture and adolescent athlete.

Study design: Clinical review.

Level of evidence: Level 3.

Results: Excellent outcomes and rapid return to competition can be achieved with surgical management of displaced clavicle fractures in the adolescent athlete with high functional demands similar to those of their adult counterparts. Complications include hardware irritation, screw loosening, pin migration, peri-incisional numbness, and refracture. Athletes and families must be counseled regarding complications and potential need for secondary surgery to remove hardware.

Conclusion: The adolescent athlete with a displaced, shortened, or comminuted clavicle fracture presents a unique, controversial dilemma for the surgeon. Earlier return to competition can be achieved with surgical management to restore length and alignment and may prevent malunion, nonunion, and poor outcomes.

Keywords: adolescent athlete; clavicle fracture; displaced midshaft clavicle fracture.

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Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article.

Figures

Figure 1.
Figure 1.
Anteroposterior radiograph showing a middle third diaphyseal clavicle fracture in a 14-year-old boy.
Figure 2.
Figure 2.
Middle third diaphyseal clavicle fracture with skin tenting and potential compromise in a 15-year-old girl. (a) Anteroposterior radiograph shows a middle third diaphyseal clavicle fracture with severe displacement. (b) Anteroposterior radiograph at 12 weeks after surgery shows a successful anatomic restoration and radiographic union.
Figure 3.
Figure 3.
Middle third comminuted diaphyseal clavicle fracture in a 16-year-old male patient. (a) Anteroposterior radiograph shows a middle third diaphyseal clavicle fracture with comminution and a Z-shaped fragment. (b) Anteroposterior radiograph at 10 weeks after surgery shows a successful anatomic restoration and radiographic union.
Figure 4.
Figure 4.
Middle third diaphyseal clavicle fracture malunion in a 10-year-old boy. (a) Anteroposterior radiograph shows a middle third diaphyseal clavicle fracture with complete displacement and extensive shortening. (b) Anteroposterior radiograph 15 weeks later shows radiographic malunion.
Figure 5.
Figure 5.
Middle third diaphyseal clavicle fracture requiring hardware removal in a 17-year-old male patient. (a) Anteroposterior radiograph shows a middle third diaphyseal clavicle fracture with complete displacement and shortening. (b) Anteroposterior radiograph at 12 weeks after surgery shows radiographic union and prominent lateral hardware requiring removal.
Figure 6.
Figure 6.
Surgical management of a clavicle fracture in a 16-year-old male patient. (a) Anteroposterior radiograph demonstrating a middle third diaphyseal clavicle fracture with complete displacement and extensive shortening. (b) Anteroposterior radiograph 5 months after surgery shows successful anatomic restoration and radiographic union.
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References

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