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Purpose: It is still controversial whether complete displaced mid-shaft clavicle fractures should be treated with internal fixation or conservative therapy. This retrospective study aims to compare clinical outcomes of two treatment protocols.

Materials and Methods: 105 patients with displaced and comminuted mid-shaft clavicle fractures were included in this study, among which 55 patients were treated conservatively and 50 patients accepted surgical fixation and were followed up for over 20 months on average. Rate of union, malunion, time taken for union, functional outcome, self-reported satisfaction and complications were compared.

Results: Union rate of operative group (n=49, 98.0%) was higher than the non-operative group (n=48, 87.3%). Time taken for union in operative group (2.37±1.06 months) was shorter than the non-operative group (3.69±1.01 months). Malunion and asymmetric were only seen in the conservative group. Numbness of the shoulder was only reported in the operative group (n=23, 46.0%). Most of patients in the operative group (n=45, 90%) accepted a second operation to remove the implant. No statistically difference was found in self-reported satisfaction, Quick-DASH and Constant-Murley score. The operative group returned to work faster (1.47±0.89 to 3.34±1.37 months), regained full range of motion earlier (1.66±0.78 to 3.83±1.24 months) and regained strength faster (3.86±2.45 to 8.03±2.78 months) than the non-operative group.

Conclusion: Complete displaced and comminuted mid-shaft clavicle fractures treated surgically have more reliable union and faster recovery when compared to conservatively treated fractures.

Titel:	Comprehensive comparison between conservative therapy and surgical management for completely displaced and comminuted mid-shaft clavicle fractures.
Autor/in / Beteiligte Person:	Han, X ; Zhang, Y ; Zhang, X ; Tan, J
Link:	View record at Springer (Volltext)
Zeitschrift:	International orthopaedics, Jg. 48 (2024-07-01), Heft 7, S. 1871-1877
Veröffentlichung:	Berlin : Springer Verlag, 2024
Medientyp:	academicJournal
ISSN:	1432-5195 (electronic)
DOI:	10.1007/s00264-024-06198-1
Schlagwort:	Humans Male Female Adult Retrospective Studies Middle Aged Treatment Outcome Young Adult Fractures, Bone surgery Fractures, Bone therapy Fracture Healing Patient Satisfaction Clavicle injuries Clavicle surgery Fractures, Comminuted surgery Conservative Treatment methods Fracture Fixation, Internal methods Fracture Fixation, Internal adverse effects
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Comparative Study Language: English [Int Orthop] 2024 Jul; Vol. 48 (7), pp. 1871-1877. <i>Date of Electronic Publication: </i>2024 May 07. MeSH Terms: Clavicle* / injuries ; Clavicle* / surgery ; Fractures, Comminuted* / surgery ; Conservative Treatment* / methods ; Fracture Fixation, Internal* / methods ; Fracture Fixation, Internal* / adverse effects ; Humans ; Male ; Female ; Adult ; Retrospective Studies ; Middle Aged ; Treatment Outcome ; Young Adult ; Fractures, Bone / surgery ; Fractures, Bone / therapy ; Fracture Healing ; Patient Satisfaction Comments: Comment in: Int Orthop. 2024 Jun 13. doi: 10.1007/s00264-024-06237-x. (PMID: 38869521) References: Postacchini F, Gumina S, De Santis P et al (2002) Epidemiology of clavicle fractures. J Shoulder Elb Surg 11(5):452–456. 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Comprehensive comparison between conservative therapy and surgical management for completely displaced and comminuted mid-shaft clavicle fractures.