The aetiology and epidemiology of clavicular fractures: A prospective study during a two-year period in Uppsala, Sweden
Introduction
Clavicular fractures are frequent injuries as they constitute approximately 4% of all fractures in adults and about 35% of all fractures that occur in the shoulder region. Of fractures in the shoulder region it is only fractures through the proximal humerus that are more common in adults [1], [2]. Only a few studies describing the aetiology and epidemiology of clavicular fractures have been published, and to the best of our knowledge none of the previously published reports have been prospective [1], [3], [4].
The aim with this prospective study was to define the age- and gender-specific incidence with correlation to seasonal changes and with special reference to differences between genders. We also set out to define fracture causes, the fracture site distribution of the clavicle and the incidence of non-union during a two-year period in a well-defined population.
Section snippets
Patients and methods
During a two-year period (1 January 1989 to 31 December 1990), all patients living in the county of Uppsala, Sweden, with a radiologically verified fracture of the clavicle were prospectively included in the present study. Throughout the study period, there were 11 radiological departments within the county, all of which participated in the study. Data on all patients, 15 years of age or older, with a radiographically verified fracture of the clavicle were sent to one of the authors (J. Nowak).
Statistical analysis
The Mann–Whitney non-parametric test, chi-square test, Fisher’s exact test, unpaired t test, contingency table analysis and ANOVA with Fisher’s post hoc test were used to compare groups. Statistical significance was defined as p<0.05. Mean and standard deviations are given.
Results
During 1989 (n=95) and 1990 (n=92), there were 187 clavicular fractures in 185 patients above 15 years of age, with a male/female distribution of 2.2:1. The annual incidence was 50.3/100,000 for the entire population with a significant higher incidence in men (71.1/100,000) compared with women (30.5/100,000) (p<0.0001). There was no significant difference in the annual incidence or gender distribution between the two years.
Patients who suffered a fracture through the acromial or middle part of
Discussion
The finding that clavicular fractures are more frequent in men is in accordance with previous studies where a male predominance between 1.4:1 and 3.6:1 have been reported [1], [5], [6], [7], [8], [9], [10].
The overall incidence was fairly similar in this study to a retrospective study from the southern part of Sweden [1], while almost twice as high as the incidence reported in the Edinburgh area in a retrospective study by Robinson [3]. The incidence was highest in the youngest part of the
Acknowledgements
The authors are grateful to Margareta Holgersson for the statistical analysis.
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