![]() The landmark study compared outcomes of operative and non-operative treatment for clavicle fractures in patients between the ages of 10 and 18. Adult protocol increases risk for adolescents By pooling their data, members of FACTS gained the ability to study larger groups of adolescents with fractured clavicles. The lack of adolescent-specific evidence became the driving force behind FACTS (Function after Adolescent Clavicle Fracture Trauma and Surgery), a multicenter study group of eight pediatric hospitals including Boston Children’s. ![]() “As the pendulum shifted to more surgeries for clavicle fractures, pediatric orthopedists weren’t sure whether the study results were applicable to their adolescent patients,” says Benton Heyworth, MD, of Boston Children’s Orthopedic Center. While the 2007 study demonstrated that adults who underwent surgery for clavicle fractures had fewer complications, it left the question of adolescent outcomes unanswered. The study, published in the American Journal of Sports Medicine, could mark another shift in the care of clavicle fractures in adolescents, the sub-population most affected by this injury. Now, a landmark study at Boston Children’s Hospital demonstrates that in adolescents, treating clavicle fractures with surgery carries more risks than non-operative treatment and does not appear to offer clear benefits over non-operative treatment. Although the study participants were adults, the rate of surgical treatment subsequently increased across all age groups. ![]() ![]() That changed after a 2007 study reported better shoulder function after plate-fixation surgery. Until about 15 years ago, most clavicle fractures were allowed to heal with minimal medical intervention. Unlike in adults, the risk of failed bone healing is exceedingly rare in adolescents with clavicle fractures. ![]()
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