Epidemiology of clavicle shaft fractures in a public hospital in South Africa: differences between developing and developed countries

Purpose Describing the epidemiological profile of patients with acute clavicle shaft fractures in a developing country public state hospital where mainly low- to middle-income patients are treated. Methods This is a retrospective analysis of all clavicle shaft fractures between 2008 and 2018 (10 years) based on Picture Archiving and Communication System at the second largest public hospital in South Africa. Results One thousand and three patients, 729 male and 274 female, were included in the epidemiological review. Most common causes of clavicle shaft fractures, in which 23% of cases presented with other injuries, were road accidents, falls and interpersonal violence. The majority of fractures were displaced and most (72%) were treated conservatively. Only 28% of patients were treated surgically, 61% with contoured plating and a relatively high 39% with intramedullary nails. Conclusion The epidemiology of clavicle shaft fractures in a public hospital in a developing country, where the majority of patients hail from low- to middle-income backgrounds, differs substantially from developed countries. Although similar types of fractures were reported, differences were noted in terms of patients' age, causes of injury, associated injuries and treatment approaches.