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. 2022 Oct;48(5):3513-3520.
doi: 10.1007/s00068-021-01701-4. Epub 2021 Jun 1.

Epidemiology of combined clavicle and rib fractures: a systematic review

Arthur A R Sweet  1 , Reinier B Beks  2 , Frank F A IJpma  3 , Mirjam B de Jong  4 , Frank J P Beeres  5 , Luke P H Leenen  4 , Roderick M Houwert  4 , Mark C P M van Baal  4
Affiliations

Epidemiology of combined clavicle and rib fractures: a systematic review

Arthur A R Sweet et al. Eur J Trauma Emerg Surg. 2022 Oct.

Abstract

Purpose: The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries.

Methods: A systematic literature search was performed in the MEDLINE, EMBASE, and CENTRAL databases on the 14th of August 2020. Outcome measures were incidence, hospital length of stay (HLOS), intensive care unit admission and length of stay (ILOS), duration of mechanical ventilation (DMV), mortality, chest tube duration, Constant-Murley score, union and complications.

Results: Seven studies with a total of 71,572 patients were included, comprising five studies on epidemiology and two studies on treatment. Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 56-60.6% versus 29% in patients without clavicle fractures. Vice versa, 14-18.8% of patients with multiple rib fractures had concomitant clavicle fractures compared to 7.1% in patients without multiple rib fractures. One study reported no complications after fixation of both injuries. Another study on treatment, reported shorter ILOS and less complications among operatively versus conservatively treated patients (5.4 ± 1.5 versus 21 ± 13.6 days).

Conclusion: Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. Definitive conclusions could not be drawn on treatment of the combined injury. Future research should further investigate indications and benefits of operative treatment of this injury.

Keywords: Clavicle fractures; Epidemiology; Rib fractures; Treatment.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram representing the search and screen process of articles describing patients with combined clavicle and rib fractures
See this image and copyright information in PMC

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