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.