Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 1;12(1):2-8.
doi: 10.1302/1863-2548.12.170155.

Clavicle fracture nonunion in the paediatric population: a systematic review of the literature

K Hughes  1 , J Kimpton  1 , R Wei  1 , M Williamson  1 , A Yeo  1 , M Arnander  1 , Y Gelfer  1   2
Affiliations

Clavicle fracture nonunion in the paediatric population: a systematic review of the literature

K Hughes et al. J Child Orthop. .

Abstract

Aims: Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes.

Methods: We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years. Data was collected on patient demographics, fracture type, mechanism of injury (MOI), surgical intervention and reported outcome. Two independent reviewers evaluated all the data.

Results: A total of 13 articles reporting 21 cases of clavicle fracture nonunion were identified. The mean age at time of injury was 11.4 years (4 to 17). Falls were the most common MOI. The majority of nonunions occurred after displaced fractures on the right side. Six were refractures. Mean time of presentation following injury was 13.5 months (4 to 60). In all, 16 were treated surgically. Radiographic union was eventually achieved in 12 cases, with functional outcome satisfactory in all cases.

Conclusion: Clavicle nonunion is an extremely rare but possible complication in children. The majority occur after displaced right-sided fractures or refractures and present around one year after injury. Surgical fixation provides good radiographic healing and functional outcomes.

Level of evidence: IV.

Keywords: Clavicle; fracture; nonunion; paediatric.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram of data selection process.
See this image and copyright information in PMC

References

    1. Rennie L, Court-Brown CM, Mok JYQ, Beattie TF.. The epidemiology of fractures in children. Injury 2007;38:913-922. - PubMed
    1. Calder JDF, Solan M, Gidwani S, Allen S, Ricketts DM.. Management of paediatric clavicle fractures--is follow-up necessary? An audit of 346 cases. Ann R Coll Surg Engl 2002;84:331-333. - PMC - PubMed
    1. Kessler J, Gardner I, Corral J.. Pediatric clavicular shaft fractures treated nonoperatively: assessment of treatment results, fracture patterns, modes of injury, and patient demographics. Annual Meeting of the Pediatric Orthopaedic Society of America 2009;30.
    1. Strauss BJ, Carey TP, Seabrook JA, Lim R.. Pediatric clavicular fractures: assessment of fracture patterns and predictors of complicated outcome. J Emerg Med 2012;43:29-35. - PubMed
    1. Wilkes JA, Hoffer MM.. Clavicle fractures in head-injured children. J Orthop Trauma 1987;1:5-58. - PubMed

LinkOut - more resources