J Korean Orthop Assoc.  2016 Dec;51(6):455-463. 10.4055/jkoa.2016.51.6.455.

An Epidemiological Study of Clavicle Fractures for Koreans in the Metropolitan Area

• Baek JK
• Lee YH
• Choi HS
• Lee YJ
• Kim MB
• Baek GH

• KMID: 2364296
• DOI: http://doi.org/10.4055/jkoa.2016.51.6.455

Abstract

PURPOSE
Though clavicle fractures are the second most common fractures to occur in active adults, there have been a few epidemiological studies conducted on the Korean population in recent years. To better understand clavicle fractures, an epidemiological study reflecting the changes in current life style and injury mechanism may be important. Hence, the purpose of this study was to conduct an epidemiological study on the Korean population.
MATERIALS AND METHODS
This was a retrospective study of 973 patients (977 cases) who presented with clavicle fractures from January 2000 to August 2015. Radiological results were classified by the Allman system-3 groups and 7 subgroups. The study collected information regarding gender, age at the event of injury, injury mechanism, other associated injuries, occurrence rate of each year, and seasonal variation.
RESULTS
The study consisted of 627 male patients (64.4%, 1 bilateral case) and 346 female patients (35.6%, 3 bilateral cases). The mean age at the time of injury was 31.8±24.9 years (male, 31.2±22.6 years; female, 32.7±28.7 years). Midshaft clavicle fractures (Allman group I) were the most common with 758 cases (77.6%). There were 397 cases with displacement (40.6%). The occurrence of clavicle fractures decreased with increasing age in male patients and showed a bimodal distribution in female patients. Injury due to a fall from standing height was the most common mechanism of injury. There were 61 cases (6.2%) who had other associated injuries and the most common associated injury was a rib fracture. The occurrence of clavicle fractures increased with time, and falling was associated with the highest occurrence rate of clavicle fractures.
CONCLUSION
The mean age of clavicle fracture was 31.8 years in a recent 15-year period. The occurrence of fracture in male patients was 1.8 times than female patients, primarily occurring as midshaft fractures. There were more cases of displacement than minimally displaced cases. The most common injury mechanism was a fall from standing height, and the occurrence of clavicle fractures has shown an increasing trend recently.

Keyword

clavicle; epidemiologic studies

MeSH Terms

Accidental Falls
Adult
Clavicle*
Epidemiologic Studies*
Female
Humans
Life Style
Male
Retrospective Studies
Rib Fractures
Seasons

Figure

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  Fig. 1 Male patients showed a higher occurrence than female in all clavicle fracture subgroups. Especially, male patients showed a two-fold higher occurrence than female patients in displaced clavicle fractures (Allman group Ib, Ic, IIb). I, midshaft; II, distal; III, medial; a, minimally displaced; b, displaced; c, segmental.

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  Fig. 2 The occurrence of clavicle fractures decreased with increasing age in male patients and showed a bimodal distribution in female patients.

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  Fig. 3 The occurrence of clavicle fracture increased with time for the last 15 years.

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  Fig. 4 The occurrence of clavicle fractures showed a seasonal variation. This showed the lowest occurrence in the spring and the highest in the autumn. Spring, March to May; Summer, June to August; Autumn, September to November; Winter, December to February.

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  Fig. 5 The occurrence of clavicle fracture due to a fall from standing height according to the gender shows a high rate in the infant period of both genders. The occurrence of clavicle fracture decreased with increasing age in male patients and showed a bimodal distribution (second peak in 60's and 70's years) in female patients.

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  Fig. 6 The occurrence of clavicle fractures due to a fall from standing height has been increasing regardless of gender for the last 15 years.

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  Fig. 7 The occurrence of clavicle fractures due to bicycle has been steadily increasing for the last 15 years. It seems to be related to an increase in the number of bicycles and the development of bicycle roads.

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