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MINERVA PEDIATRICA

Rivista di Pediatria, Neonatologia, Medicina dell’Adolescenza
e Neuropsichiatria Infantile


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Minerva Pediatrica 2018 Apr 12

DOI: 10.23736/S0026-4946.18.05101-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Does age affect outcome in children with clavicle fracture treated conservatively? QuickDash and MRC evaluation of 131 consecutive cases

Vito PAVONE 1, Claudia DE CRISTO 1, Gianluca TESTA 1 , Federico CANAVESE 2, Ludovico LUCENTI 1, Giuseppe SESSA 1

1 Department of Orthopaedics, University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy; 2 Pediatric Surgery Department, University Hospital Estaing, Clermont Ferrand, France


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BACKGROUND: Non-operative treatment with immobilization is the gold-standard for paediatric clavicular fractures. Purpose of this study is to evaluate functional outcomes and efficacy of non-operative treatment of clavicular fractures in a succession of 131 children.
METHODS: Between 2006 and 2012, we treated non-surgically 131 children for a clavicular fracture. All fractures have been classified according to Robinson classification. Clavicle shortening, range of movements and muscular strength through the Medical Research Council (MRC) scale were evaluated. To assess the outcomes, QuickDASH questionnaire, dividing the sample in 3 age-related group, was administered.
RESULTS: The average follow-up was 26 months (8-84 months). Clavicle shortening at the time of injury occurred in 18 cases. All fractures reached union. Average time to union was 34 days. Mean time return to activity was 12.6 weeks. No cases of nonunion or delayed union were reported. Complications occurred in 21 cases. A shortening persisted in 2 cases. Only one patient had a slight functional restriction. Average QuickDASH score was 6.2±1.1 (range 4.3-9.4). All patients recovered to a MRC score of 5, except for one patient with a score of 4. Best QuickDASH scores were observed in the group aged under 8 years and in non-comminuted and lateral third fractures of the clavicle.
CONCLUSIONS: Observing results, clavicle fractures have a satisfactory clinical healing as shown by the good scores at QuickDASH and MRC scale. Younger children under 8 years can achieve the best results with a conservative treatment in terms of bone healing and activity level.


KEY WORDS: Clavicle fractures - Children - Conservative treatment - QuickDASH - MRC scale

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Publication History

Article first published online: April 12, 2018
Manuscript accepted: March 8, 2018
Manuscript revised: January 30, 2018
Manuscript received: September 25, 2017

Per citare questo articolo

Pavone V, De Cristo C, Testa G, Canavese F, Lucenti L, Sessa G. Does age affect outcome in children with clavicle fracture treated conservatively? QuickDash and MRC evaluation of 131 consecutive cases. Minerva Pediatr 2018 Apr 12. DOI: 10.23736/S0026-4946.18.05101-0

Corresponding author e-mail

gianpavel@hotmail.com