Adolescent Clavicle Fractures: A Management Dilemma?

Clavicle fractures are among the most common orthopaedic injuries in adolescents, particularly male athletes, arising primarily from sports-related trauma and vehicular accidents. While non-operative treatment remains the standard approach due to favourable recovery outcomes and lower complication rates, the trend toward surgical fixation has gained traction, driven by emerging studies suggesting potential benefits in certain cases. This review critically examines the indications, outcomes, and complications associated with both conservative and operative management of adolescent clavicle fractures. Non-operative treatment demonstrates high healing rates, minimal long-term functional deficits, and excellent patient satisfaction. Conversely, operative interventions, including plate fixation and intramedullary nailing, are associated with improved alignment in displaced fractures but carry risks of hardware-related complications, such as implant irritation, hardware failure, and the necessity for removal surgeries. The role of surgical intervention remains controversial, with no definitive consensus or Level 1 evidence favouring one approach over the other.