Influence of surgical stabilization of clavicle fractures in multiply-injured patients with thoracic trauma

• Published in: Scientific reports Vol. 11; no. 1; pp. 23263 - 9
• Main Authors: Eberbach, Helge, Lefering, Rolf, Hager, Sven, Schumm, Klaus, Bode, Lisa, Jaeger, Martin, Maier, Dirk, Kalbhenn, Johannes, Hammer, Thorsten, Schmal, Hagen, Bayer, Jörg
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/699; 692/699/578; Accidents, Traffic; Adult; Aged; Clavicle; Clavicle - injuries; Clavicle - surgery; Female; Fractures; Fractures, Bone - surgery; Humanities and Social Sciences; Humans; Injury Severity Score; Intensive Care Units; Intubation; Length of Stay; Lungs; Male; Middle Aged; multidisciplinary; Multiple organ dysfunction syndrome; Multiple Trauma - complications; Multiple Trauma - surgery; Patients; Registries; Retrospective Studies; Science; Science (multidisciplinary); Thoracic Injuries - surgery; Thorax; Trauma; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-02771-5

Thoracic trauma has decisive influence on the outcome of multiply-injured patients and is often associated with clavicle fractures. The affected patients are prone to lung dysfunction and multiple organ failure. A multi-center, retrospective analysis of patient records documented in the TraumaRegister DGU was performed to assess the influence of surgical stabilization of clavicle fractures in patients with thoracic trauma. A total of 3,209 patients were included in the analysis. In 1362 patients (42%) the clavicle fracture was treated operatively after 7.1 ± 5.3 days. Surgically treated patients had a significant reduction in lung failure (p = 0.013, OR = 0.74), multiple organ failure (p = 0.001, OR = 0.64), intubation time (p = 0.004; −1.81 days) and length of hospital stay (p = 0.014; −1.51 days) compared to non-operative treatment. Moreover, surgical fixation of the clavicle within five days following hospital admission significantly reduced the rates of lung failure (p = 0.01, OR = 0.62), multiple organ failure (p = 0.01, OR = 0.59) and length of hospital stay (p = 0.01; −2.1 days). Based on our results, multiply-injured patients with thoracic trauma and concomitant clavicle fracture may benefit significantly from surgical stabilization of a clavicle fracture, especially when surgery is performed within the first five days after hospital admission.