Epidemiology, associated injuries, and surgical intervention of 255,081 clavicle fractures in the United States from 2015 to 2024

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BACKGROUND: Clavicle fractures are a relatively common injury and are often associated with other injuries, especially those of the thorax. While they have traditionally been treated conservatively, rates of surgical intervention have been reportedly increasing. This study investigates recent epidemiological trends and demographic distributions of clavicle fractures in the US. Additionally, it reports on rates of injuries associated with clavicle fractures and on rates and trends of surgical intervention for clavicle fractures. METHODS: The TriNetX US Collaborative Network database was used to identify patients who experienced a clavicle fracture in the US from 2015 to 2024. The primary outcome was incidence proportion (IP), stratified by both age and sex. Rates of associated injuries and surgical treatment were also assessed. RESULTS: A total of 255,081 patients were identified as having a clavicle fracture in the US TriNetX database from 2015 through 2024. The average yearly IP was 52.11 cases per 100,000 patients. From 2015-2024, the IP increased by 68.2%. Males made up 64% of the cohort and had a larger IP than females every year. The mean age was 35 ± 27 and the age-stratified IP followed a bimodal distribution, with the highest values in those under 19 and over 80. Rib fractures (14%) were the most common associated injury assessed. Overall, 7.5% were treated with ORIF. The percentage treated surgically increased from 2015 (6.40%) to 2021 (8.73%) and decreased slightly through 2024 (8.56%). The highest percentage treated by ORIFs were in the 20-24 (17.70%) and 25-29 (17.59%) age groups, while the lowest percentage were in the 0-4 (0.06%), 5-9 (0.47%) and 85 + (0.91%) age groups. CONCLUSIONS: Clavicle fractures in the US appear to be increasing. They occur more in males and demonstrate a bimodal age distribution. They are associated with many other injuries, especially rib fractures. Rates of surgical intervention have increased and are highest in young adults and lowest in pediatric and elderly patients. These results can be used to identify at-risk populations and commonly associated injuries to screen for with clavicle fracture presentations, and they show changes in orthopaedic care and its age variation.

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