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Epidemiology of clavicle shaft fractures in a public hospital in South Africa: differences between developing and developed countries

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Describing the epidemiological profile of patients with acute clavicle shaft fractures in a developing country public state hospital where mainly low- to middle-income patients are treated.

Methods

This is a retrospective analysis of all clavicle shaft fractures between 2008 and 2018 (10 years) based on Picture Archiving and Communication System at the second largest public hospital in South Africa.

Results

One thousand and three patients, 729 male and 274 female, were included in the epidemiological review. Most common causes of clavicle shaft fractures, in which 23% of cases presented with other injuries, were road accidents, falls and interpersonal violence. The majority of fractures were displaced and most (72%) were treated conservatively. Only 28% of patients were treated surgically, 61% with contoured plating and a relatively high 39% with intramedullary nails.

Conclusion

The epidemiology of clavicle shaft fractures in a public hospital in a developing country, where the majority of patients hail from low- to middle-income backgrounds, differs substantially from developed countries. Although similar types of fractures were reported, differences were noted in terms of patients’ age, causes of injury, associated injuries and treatment approaches.

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References

  1. Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. J Bone Joint Surg Am. 2009;91(2):447–60. https://doi.org/10.2106/JBJS.H.00034.

    Article  PubMed  Google Scholar 

  2. Nowak J, Mallmin H, Larsson S. The aetiology and epidemiology of clavicular fractures. A prospective study during a two-year period in Uppsala Sweden. Injury. 2003;31(5):353–8. https://doi.org/10.1016/s0020-1383(99)00312-5.

    Article  Google Scholar 

  3. Herteleer M, Winckelmans T, Hoekstra H, Nijs S. Epidemiology of clavicle fractures in a level 1 trauma center in Belgium. Eur J Trauma Emerg Surg. 2018;44(5):717–26. https://doi.org/10.1007/s00068-017-0858-7.

    Article  CAS  PubMed  Google Scholar 

  4. Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elb Surg. 2002;11(5):452–6. https://doi.org/10.1067/mse.2002.126613.

    Article  Google Scholar 

  5. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg. 1998;80(3):476–544. https://doi.org/10.1302/0301-620x.80b3.8079.

    Article  CAS  Google Scholar 

  6. Kihlström C, Möller M, Lönn K, Wolf O. Clavicle fractures: epidemiology, classification and treatment of 2422 fractures in the Swedish fracture register; an observational study. BMC Musculoskelet Disord. 2017;18(1):82. https://doi.org/10.1186/s12891-017-1444-1.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Huttunen TT, Launonen AP, Berg HE, Lepola V, Felländer-Tsai L, Mattila VM. Trends in the incidence of clavicle fractures and surgical repair in Sweden: 2001–2012. J Bone Joint Surg Am. 2016;98(21):1837–42. https://doi.org/10.2106/JBJS.15.01284.

    Article  PubMed  Google Scholar 

  8. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res. 1994;300:127–32.

    Article  Google Scholar 

  9. Stanley D, Trowbridge EA, Norris SH. The mechanism of clavicular fracture. A clinical and biomechanical analysis. J Bone Joint Surg Br. 1988;70(3):461–4. https://doi.org/10.1302/0301-620X.70B3.3372571.

    Article  CAS  PubMed  Google Scholar 

  10. Matzopoulos RG, Prinsloo M, Butchart A, Peden MM, Lombard CJ. Estimating the South African trauma caseload. Int J Inj Contr Saf Promot. 2006;13(1):49–51. https://doi.org/10.1080/15660970500036382.

    Article  PubMed  Google Scholar 

  11. Xu C-P, Li X, Cui Z, Diao X-C, Yu B. Should displaced midshaft clavicular fractures be treated surgically? A meta-analysis based on current evidence. Eur J Orthop Surg Traumatol. 2013;23(6):621–9. https://doi.org/10.1007/s00590-012-1063-3.

    Article  PubMed  Google Scholar 

  12. Ban I, Nowak J, Virtanen K, Troelsen A. Overtreatment of displaced midshaft clavicle fractures. Acta Orthop. 2016;87(6):541–5. https://doi.org/10.1080/17453674.2016.1191275.

    Article  PubMed  PubMed Central  Google Scholar 

  13. King PR, Eken MM, Ikram A, Lamberts RP. The effectiveness of a flexible locked intramedullary nail and an anatomically contoured locked plate to treat clavicle shaft fractures - a one-year randomized control trial. J Bone Joint Surg Am. 2019;101(7):628–34. https://doi.org/10.2106/JBJS.18.00660.

    Article  PubMed  Google Scholar 

  14. King PR, Lamberts RP. Management of clavicle shaft fractures with intramedullary devices: a narrative review. Expert Rev Med Devices. 2020;17(8):807–15. https://doi.org/10.1080/17434440.2020.1793668.

    Article  CAS  PubMed  Google Scholar 

  15. Badenhorst DHS, van der Westhuizen CA, Britz E, Burger MC, Ferreira N. Lost to follow-up: challenges to conducting orthopaedic research in South Africa. S Afr Med J. 2018;108(11):917–21. https://doi.org/10.7196/SAMJ.2018.v108i11.13252.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Robert Patrick Lamberts.

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King, P.R., Eken, M.M. & Lamberts, R.P. Epidemiology of clavicle shaft fractures in a public hospital in South Africa: differences between developing and developed countries. Eur J Trauma Emerg Surg 48, 4935–4941 (2022). https://doi.org/10.1007/s00068-022-02029-3

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  • DOI: https://doi.org/10.1007/s00068-022-02029-3

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