Epidemiological changes in clavicle fractures during the COVID-19 pandemic: a six-year analysis from a large single-center cohort

Abstract

Objective To evaluate the epidemiological characteristics of clavicle fractures in a high-volume trauma center over a six-year period and to compare trauma mechanisms and management patterns before and during the COVID-19 pandemic. Methods A retrospective review of 1500 consecutive clavicle fracture cases treated at a level-one trauma center between January 2016 and December 2021 was conducted. Demographic characteristics, fracture classification, trauma mechanisms, and treatment modalities were analyzed. Comparisons were made between the pre-pandemic period (2016-March 2020) and the pandemic period (March 2020-2021). Results The cohort consisted predominantly of young males (68.5%, median age: 21.7 years). Midshaft fractures were most common (79.3%). During the pandemic, trauma mechanisms changed significantly, with a marked decrease in sports-related injuries (34.3% to 13.4%) and an increase in simple falls (46.0% to 62.9%) and high-energy trauma (19.7% to 23.7%) (p < 0.001). Despite these epidemiological shifts, the proportion of surgically treated fractures remained unchanged (8.7% pre-pandemic vs. 8.1% during the pandemic, p > 0.05). No significant differences were observed in fracture type or associated injuries between periods. Conclusion The COVID-19 pandemic was associated with substantial changes in the epidemiology of clavicle fractures, particularly in trauma mechanisms, but did not affect the rate of operative versus non-operative management. These findings suggest that while societal restrictions altered injury patterns, clinical decision-making for clavicle fracture treatment remained stable.