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

## TL;DR

This study analyzed clavicle fracture patterns before and during the pandemic, finding changes in injury causes but stable treatment rates.

## Contribution

The study reveals how societal changes during the pandemic affected injury mechanisms but not treatment decisions for clavicle fractures.

## Key findings

- Sports-related injuries decreased significantly during the pandemic, while simple falls and high-energy trauma increased.
- Despite changes in trauma mechanisms, the rate of surgical treatment for clavicle fractures remained stable.
- Young males were the most common demographic for clavicle fractures over the six-year period.

## Abstract

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.

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).

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.

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.

III (Retrospective comparative study).

The online version contains supplementary material available at 10.1186/s13018-025-06634-x.