Abstract
Purpose: The purpose of this study was to assess if the use of the “endobutton” technique via an arthroscopically-assisted approach was associated with good patient reported outcome measures and low complication rates in select adolescent patients with displaced lateral third clavicle fractures. Methods: A retrospective review of displaced lateral third clavicle fractures sustained in adolescents treated operatively using the endobutton technique over a 2 year period was carried out at our institution. Four cases were identified, all sustained while involved in sporting activities and all were treated via an arthroscopically-assisted approach. Results: all 4 patients scored 0 on the Quick DASH assessment score. No hardware required removal and all patients returned to sport at the same level. Conclusions: Displaced lateral clavicle fractures in adolescents can pose a significant challenge in terms of management options. Use of the endobutton technique via an arthroscopic-assisted approach can offer a safe and effective means of treatment with excellent patient reported outcomes and low complications rates. Level of Evidence: 4 Keywords: lateral clavicle; adolescent; arthroscopicassisted
Highlights
Fractures of the clavicle account for almost 15% of all fractures seen in adolescents. [1,2] The majority of fractures occur in the middle third or midshaft region with lateral third or distal fractures accounting for approximately one quarter. [1,2,3,4,5,6] The most commonly affected patients are those aged between 13 and 20 years with the propensity for males being 2.5 times that for females
There is currently no level 1 evidence to guide the surgical treatment of clavicle fractures in the adolescent population and as such it has been mainly led by evidence deduced from adult studies. [7,10] The clavicle reaches 80% of its growth by age 9 and 12 in girls and boys respectively and so this impacts on adolescent remodelling potential. [11]
O’ Reilly et al / International Journal of Orthopaedics Traumatology & Surgical Sciences 2020;6(1):30–34 treatment of adolescent displaced lateral clavicle fractures and the purpose of this case series is to present our experience of this modality in terms of operative approach and patient outcomes
Summary
Fractures of the clavicle account for almost 15% of all fractures seen in adolescents. [1,2] The majority of fractures occur in the middle third or midshaft region with lateral third or distal fractures accounting for approximately one quarter. [1,2,3,4,5,6] The most commonly affected patients are those aged between 13 and 20 years with the propensity for males being 2.5 times that for females. [7] The incidence of clavicle fracture is estimated to be between 29 and 64 per 100,000 population with the main mechanism of injury being associated with sports. [7,8,9]There is currently no level 1 evidence to guide the surgical treatment of clavicle fractures in the adolescent population and as such it has been mainly led by evidence deduced from adult studies. [7,10] The clavicle reaches 80% of its growth by age 9 and 12 in girls and boys respectively and so this impacts on adolescent remodelling potential. [11]Following our review of the literature there are no studies looking at the use of the endobutton technique for theO’ Reilly et al / International Journal of Orthopaedics Traumatology & Surgical Sciences 2020;6(1): treatment of adolescent displaced lateral clavicle fractures and the purpose of this case series is to present our experience of this modality in terms of operative approach and patient outcomes. Fractures of the clavicle account for almost 15% of all fractures seen in adolescents. [7] The incidence of clavicle fracture is estimated to be between 29 and 64 per 100,000 population with the main mechanism of injury being associated with sports. There is currently no level 1 evidence to guide the surgical treatment of clavicle fractures in the adolescent population and as such it has been mainly led by evidence deduced from adult studies. O’ Reilly et al / International Journal of Orthopaedics Traumatology & Surgical Sciences 2020;6(1): treatment of adolescent displaced lateral clavicle fractures and the purpose of this case series is to present our experience of this modality in terms of operative approach and patient outcomes
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