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Clavicular fractures

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

  • Of 540 studies reviewed, three studies described clavicular fractures 1-3
  • Study designs: 2 case-control 2,3, 1 case series 1
  • Age range: 0 – 5 years
  • Clavicular fractures were more common in abused children than those who were accidentally injured (p<0.001) for children less than 18 months and for those 18 – 48 months 2
  • For a child aged less than four years with a clavicular fracture the odds ratio (OR) for abuse is 4.4 (95% confidence interval (CI) 1.9, 10.2) p=0.001 2
  • Clavicular fractures were identified in 18% of abused children less than 18 months versus 5% of those accidentally injured 3
  • For those aged 18 to 60 months, 14% of the abused children versus 12% of the accidentally injured children had clavicular fractures 3
  • One study noted that 4 of 23 abused infants had bilateral clavicular fractures due to abuse. 10 out of 23 infants had further occult fractures on skeletal survey 1

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References

  1. Barber I, Perez-Rossello JM, Wilson CR, Kleinman PK. The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatric Radiology. 2015;45(1):69-80 [Pubmed]

  2. Pandya NK, Baldwin K, Wolfgruber H, Christian CW, Drummond DS, Hosalkar HS. Child abuse and orthopaedic injury patterns: analysis at a level I pediatric trauma center. Journal of Pediatric Orthopaedics. 2009;29(6):618-625 [Pubmed]
  3. Worlock P, Stower M, Barbor P. Patterns of fractures in accidental and non-accidental injury in children: a comparative study. British Medical Journal (Clinical Research Edition). 1986;293(6539):100-102 [Pubmed]

 

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