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. 2014 Sep;2(3):210-4.
Epub 2014 Sep 15.

The Comparison of Results of Treatment of Midshaft Clavicle Fracture between Operative Treatment with Plate and Non-Operative Treatment

Mohsen Khorami  1 , Mohammad Fakour  1 , Hossein Mokarrami  1 , Hamid Reza Arti  1 , Abdolhossein Mahdi Nasab  1 , Farid Shahrivar  1
Affiliations

The Comparison of Results of Treatment of Midshaft Clavicle Fracture between Operative Treatment with Plate and Non-Operative Treatment

Mohsen Khorami et al. Arch Bone Jt Surg. 2014 Sep.

Abstract

Background: Clavicle fractures are common and usually heal without complications. In this study, we evaluated the outcomes of non-operative versus operative management of displaced fractures.

Methods: In a prospective clinical trial study, sixty-five patients with displaced clavicle mid-shaft fractures were non-randomly divided in two treatment groups. The first group underwent non-operative treatment with figure of 8 bandage (30 patients), and the other underwent operative treatment with plate fixation (35 patients). Figure of 8 bandage and 3.5 millimeter DCP plate with at least six cortical screws were used in non-operative and operative groups respectively. We followed up all patients at weeks 2, 6 and 12, and at month sixth. In addition to clinical examination and x-ray evaluation, we assessed satisfaction, DASH and Constant Shoulder Score for each individual.

Results: The average durations of union were 19.3 and 24.4 weeks in operative and non-operative groups respectively (P=0.006). Satisfaction with operative treatment was 74.3% and with non-operative treatment was 66.7%, showing no significant difference (P=0.500). The non-union rate was 5.7% in the operative group and 13.3% in the non-operative group (P=0.518). A significant difference between the two groups in terms of DASH and Constant Shoulder Scores after the six-month follow-up was not found (P=0.352).

Conclusions: According to our results, we recommend operative treatment in mid-shaft clavicle fractures only when there is a definitive indication.

Keywords: Clavicle; Constant Shoulder Score; DASH score; Internal fixation; Non-operative management.

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Figures

Figure 1.
Figure 1.
Left clavicle fracture of a 18 years old man who was treated by non-surgical technique.
See this image and copyright information in PMC

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