DIAPHYSEAL FRACTURES OF THE CLAVICLE

Introduction: clavicle fractures are common, especially in people under 25 years of age involved in sports, falls from heights or traffic accidents. Traditionally they were treated orthopedically, reserving surgery for exceptional cases. However, recent studies have shown that orthopedic treatment may increase the incidence of complications. Objective: to detail current information related to diaphyseal clavicle fractures, anatomy, mechanism of action, etiology, epidemiology, classification, evaluation, treatment and complications. Methodology: a total of 30 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: clavicle fractures, shoulder fractures, shoulder trauma, upper limb fractures, clavicular osteosynthesis. Results: clavicle fractures represent between 2% and 10% of all bone fractures, affecting mainly young active and elderly people due to low energy falls. The most frequent mechanism of trauma is a direct fall on the shoulder, which produces a fracture in 85-94% of cases, with the middle third fracture being the most prevalent (69%). Treatment depends on the type of fracture: non-displaced fractures are managed conservatively with immobilization, while displaced fractures, especially in the distal third, may require surgery. Osteosynthesis with plate and screws is the standard approach for diaphyseal fractures, while intramedullary stabilization with elastic titanium pins shows good results, especially in pediatric patients. Conclusions: the clavicle is an anatomically vulnerable bone due to its subcutaneous location and the absence of significant muscular protection, which makes it susceptible to fractures due to direct trauma, especially in falls on the shoulder. Clavicle fractures account for a significant proportion of bone fractures, with the middle third being the most affected region in particular. Treatment of clavicle fractures should be tailored to the severity and location of the fracture, with a clear preference for a conservative approach in nondisplaced fractures of the middle third. However, in cases of displaced or complicated fractures, surgery, either by plate osteosynthesis or intramedullary fixation, is recommended to ensure proper alignment and reduce the risk of complications such as malunion and functional limitation of the shoulder. KEY WORDS: fracture, clavicle, trauma, osteosynthesis.