Experience with treatment of clavicle fractures at an African tertiary referral hospital

Abstract

Background: Clavicle fractures are common with the middle third being most frequently involved. Treatment of displaced fractures is controversial with both non-operative and operative management being advocated for. Objectives: To determine age and gender specific incidence, treatment practices and associated complications of clavicle fractures, and whether these are procedure specific, at Aga Khan University Hospital, Nairobi (AKUH, N). Design: A retrospective chart audit. Methods: The study was conducted in patients with radiologically confirmed clavicle fractures at the AKUH, N. Data were grouped on the basis of age, sex, location of fracture and treatment modality and presented as frequencies and percentages. Results: A total of 51 patients were included in the study. The male to female ratio was 3:1, with the modal age group being 30 -34 years. The middle third of the clavicle was the most commonly involved (63%), followed by the lateral (35%) and medial third (2%). Most fractures were managed non-operatively. Of the patients treated non-operatively 82% had a good outcome with no complications. Of patients treated operatively 75% had a good outcome with no complications, 17% patients required a second operation with one developing osteomyelitis and the other had failed fixation of the clavicle, and one other patient complained of pain. Conclusion: Although operative treatment is associated with early mobilization and more rigid stability it may have higher complication rates and therefore should not be used routinely.