Surgical management of clavicle fractures in Australia: an analysis of Australian Medicare Benefits Schedule database from 2001 to 2020

Abstract

AbstractBackgroundThere is no consensus on the optimal management of clavicle fractures, with advocates of both operative and non‐operative management. The objective of this study is to assess the trends in the management of clavicle fractures in Australia over the past two decades.MethodsThe incidence of surgical fixation of clavicle fractures from 2001 to 2020 was analysed using the Australian Medicare Benefits Schedule database, reflective of operations performed on privately insured patients, thus excluding public patients and compensable cases. An offset term was utilized with data from the Australian Bureau of Statistics to account for population changes over the study period.ResultsA total of 17 089 procedures for the management of clavicle fractures were performed from 2001 to 2020. The incidence of operative intervention increased from 1.87 per 100 000 in 2001 to a peak of 6.63 per 100 000 in 2016. An overall increase was seen in males (310%) and females (347%) over the study period, as well as across all age groups. A greater proportion of operative interventions was performed on males (n = 14 075, 82%) than females (n = 3014, 18%, P < 0.001). The greatest increase in intervention was noted in those aged 65 or older (14% increase per year, 95% CI 11%–17%, P < 0.05). In 2020, the incidence of operative intervention decreased to a level last seen in 2013.ConclusionsThe incidence of operative interventions for clavicle fractures has increased in Australia over the 20‐year study period. This increase is in keeping with recent evidence suggesting several advantages when displaced mid‐shaft clavicle fractures are operatively managed.