Background: Although extensive research for the optimal treatment of clavicle fractures has been performed,\ncomparative studies between monotrauma and polytrauma patients are lacking.\nObjective: To compare fracture distribution and treatment in monotrauma and polytrauma patients with a\nclavicle fracture.\nMethods: Single center retrospective cohort study. Fractures were classified by the Robinson classification.\nMonotrauma patients sustained only a clavicle fracture or a clavicle fracture plus a minor abrasion, hematoma,\nor superficial skin lesion leading to an Injury Severity Score (ISS) of 4 or 5 respectively. Polytrauma patients had\nan ISS ?16 as a result of injury in 2 or more Abbreviated Injury Scale (AIS) regions.\nResults: 154 monotrauma and 155 polytrauma patients with a clavicle fracture were identified. Monotrauma patients\nhad a higher incidence of Type IIB fractures (displaced midshaft) compared to polytrauma patients (P = 0.002). No\ndifference was observed regarding Type I (medial) and Type III (lateral) fractures. In monotrauma patients, Type IIB\nfractures were treated operatively more frequently (P = 0.004). The initial treatment for Type I and Type III fractures\ndid not differ between monotrauma and polytrauma patients.\nConclusions: Monotrauma patients had a higher incidence of displaced midshaft clavicle fractures compared to\npolytrauma patients, and monotrauma patients with displaced midshaft clavicle fractures were treated operatively\nmore frequently. No differences were found in the distribution and treatment of medial and lateral clavicle fractures.
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