Abstract
Introduction One of the most common injuries in children is clavicle fractures. They account for up to 14 % of all pediatric bone injuries. Aim Comparative evaluation of the effectiveness of surgical and conservative methods of treating closed clavicle fractures in children. Materials and methods Between 2011 and 2018, 1,800 children with clavicle fractures referred to the traumatology and orthopedic department at the Children's Clinical Hospital No. 9 in Yekaterinburg. Most of them were treated conservatively, and 94 (5.2 %) children were hospitalized for surgical treatment. Depending on age and type of displacement, children received different conservative treatments, such as Deso dressing in children under two years old, figure-eight-bandage in children over two years of age. Surgical treatment was open reduction of fragments and fixation with either a Kirschner wire or a titanium elastic nail (TEN); titanium plates were used in several cases. For a comparative assessment of the results of the treatment methods for clavicle fractures, two groups of patients were formed. Results Shortening of consolidated clavicle was not observed in children of the main group treated surgically. In several cases, the elongation of the clavicle was revealed by no more than 1 cm. Patients in the comparison group showed shortening of the broken clavicle in three cases, no more than 1.3 cm. Conclusion After surgical treatment, the length of the shoulder girdle was fully restored; insignificant shortening after conservative treatment did not cause functional disorders.
Highlights
One of the most common injuries in children is clavicle fractures
Its assessment in the immediate and longterm periods after treatment showed that the function of the upper limb on the side of the injury was fully restored in all patients in the groups of conservative and surgical treatment
The volume of initial active movements in children of the surgical group was restored on postoperative days 4–5, while in patients of the comparison group the initial active movements were restored by days 6–7
Summary
One of the most common injuries in children is clavicle fractures. They account for up to 14 % of all pediatric bone injuries. Aim Comparative evaluation of the effectiveness of surgical and conservative methods of treating closed clavicle fractures in children. For a comparative assessment of the results of the treatment methods for clavicle fractures, two groups of patients were formed. One of the most common pediatric injuries is clavicle fractures which account for up to 14 % of all bone injuries [1–6]. The majority of adult patients with fractures of the clavicle shaft undergo surgical treatment [8]. Conservative treatment of closed clavicle fractures in children is very successful and is not accompanied by complications in most cases, [2, 3]. Despite the abundance of tools proposed for the treatment of clavicle fractures, the question of the preferred method for fixation of clavicle fractures is unresolved [9]
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