Open clavicle fractures: Patterns of trauma and associated injuries

OBJECTIVES: To describe the demographic distribution, mechanism of injury, and associated injuries of patients sustaining open clavicle fractures. DESIGN: Retrospective case series. SETTING: Level I trauma center. PATIENTS/ PARTICIPANTS: Trauma registry data from all patients who required admission to the hospital from October 1995 through January 2010, specifically patients with open clavicle fractures. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENTS: The patterns of open clavicle fractures and their association with severe, nonorthopaedic injuries (head, thoracic, and great vessel). RESULTS: Fifty-three patients with open clavicle fractures were identified, and they were organized by mechanism of injury: 21 sustained blunt injuries, 26 penetrating injuries, and six not specified. No difference between blunt and penetrating injuries existed with respect to age, Injury Severity Score, inpatient days, or mortality rates. Blunt injuries were more likely associated with head injuries (52%) versus penetrating injuries (22%), but penetrating injuries were more likely associated with a great vessel injury (27% vs 7%, respectively), all statistically significant (P = 0.0487). CONCLUSIONS: Open clavicle fractures are rare injuries. Patients often have associated head, thoracic, and great vessel injuries. Penetrating injuries have higher rates of great vessel injuries and that blunt force injuries have higher rates of head injuries.