Clavicle fractures comprise 2% to 4% of adult fractures and are most common in active males under 30 years of age.[6]Song HS, Kim H. Current concepts in the treatment of midshaft clavicle fractures in adults. Clin Shoulder Elb. 2021 Sep;24(3):189-98.
https://www.doi.org/10.5397/cise.2021.00388
http://www.ncbi.nlm.nih.gov/pubmed/34488301?tool=bestpractice.com
They are caused by a fall/impact on the unprotected shoulder or more rarely a direct blow to the clavicle itself.[7]Hoogervorst P, van Schie P, van den Bekerom MP. Midshaft clavicle fractures: current concepts. EFORT Open Rev. 2018 Jun;3(6):374-80.
https://www.doi.org/10.1302/2058-5241.3.170033
http://www.ncbi.nlm.nih.gov/pubmed/30034818?tool=bestpractice.com
A large prospective cohort study found that in adolescents, clavicle fractures occurred more commonly in males during sports, secondary to a direct blow to the shoulder (60%), and on the person’s non-dominant side (56% vs. 44% on the dominant side).[8]Ellis HB, Li Y, Bae DS, et al. Descriptive epidemiology of adolescent clavicle fractures: results from the FACTS (Function after Adolescent Clavicle Trauma and Surgery) prospective, multicenter cohort study. Orthop J Sports Med. 2020 May;8(5):2325967120921344.
https://www.doi.org/10.1177/2325967120921344
http://www.ncbi.nlm.nih.gov/pubmed/32528990?tool=bestpractice.com
An observational study from the Swedish Fracture Register found that most clavicle fractures occurred in males, with a male:female ratio of 2.2:1, although in people ≥65 years clavicle fractures were more common in women than in men (male:female ratio of 0.8:1).[5]Kihlström C, Möller M, Lönn K, et al. Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study. BMC Musculoskelet Disord. 2017 Feb 15;18(1):82.
https://www.doi.org/10.1186/s12891-017-1444-1
http://www.ncbi.nlm.nih.gov/pubmed/28202071?tool=bestpractice.com
The fractures were more frequent in younger rather than older patients; the 15-24 year age group represented 21% of the study population. The fractures occurred more frequently during weekends, particularly Saturdays, and over the course of the year there was a peak in the summer months.[5]Kihlström C, Möller M, Lönn K, et al. Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study. BMC Musculoskelet Disord. 2017 Feb 15;18(1):82.
https://www.doi.org/10.1186/s12891-017-1444-1
http://www.ncbi.nlm.nih.gov/pubmed/28202071?tool=bestpractice.com
The midshaft of the clavicle is the most common fracture location and accounts for 80% of all clavicle fractures.[9]Vannabouathong C, Chiu J, Patel R, et al. An evaluation of treatment options for medial, midshaft, and distal clavicle fractures: a systematic review and meta-analysis. JSES Int. 2020 Jun;4(2):256-71.
https://www.doi.org/10.1016/j.jseint.2020.01.010
http://www.ncbi.nlm.nih.gov/pubmed/32490412?tool=bestpractice.com
The remaining fracture locations include the distal clavicle (20% to 30%) and the medial aspect of the clavicle (up to 10%).[10]Khan LA, Bradnock TJ, Scott C, et al. Fractures of the clavicle. J Bone Joint Surg Am. 2009 Feb;91(2):447-60.
http://www.ncbi.nlm.nih.gov/pubmed/19181992?tool=bestpractice.com
[11]Al-Hadithy N, Khokher ZH, Kang N, et al. The incidence of medial end clavicle fractures is higher than had previously been considered. Shoulder Elbow. 2021 Oct;13(6):600-4.
http://www.ncbi.nlm.nih.gov/pubmed/34804208?tool=bestpractice.com
Clavicle fractures are the most common fracture in the paediatric patient population, accounting for 5% to 15% of all paediatric fractures, with 90% occurring in the clavicle midshaft.[12]Schulz J, Moor M, Roocroft J, et al. Functional and radiographic outcomes of nonoperative treatment of displaced adolescent clavicle fractures. J Bone Joint Surg Am. 2013 Jul 3;95(13):1159-65.
http://www.ncbi.nlm.nih.gov/pubmed/23824383?tool=bestpractice.com
[13]Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res. 1994 Mar;(300):127-32.
http://www.ncbi.nlm.nih.gov/pubmed/8131324?tool=bestpractice.com