Research Article
Year 2022,
Volume: 13 Issue: 1, 51 - 56, 01.01.2022
Abstract
References
- 1. Su WR, Chen WL, Chen RH, et al. Evaluation of three-dimensional scapular kinematics and shoulder function in patients with short malunion of clavicle fractures. J Orthop Sci. 2016;21(6):739-44. doi:10.1016/j.jos.2016.07.005.
- 2. Ma X, Wang K, Ma J, et al. Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures. J Orthop Sci. 2020;25(2):310-4. doi: 10.1016/j.jos.2019.04.002.
- 3. Goudie EB, Clement ND, Murray IR et al. The Influence of Shortening on Clinical Outcome in Healed Displaced Midshaft Clavicular Fractures after Nonoperative Treatment. J Bone Joint Surg Am. 2017;99(14):1166-72. doi: 10.2106/JBJS.16.01010.
- 4. Malik SS, Tahir M, Jordan RW, et al. Is shortening of displaced midshaft clavicle fractures associated with inferior clinical outcomes following nonoperative management? A systematic review. J Shoulder Elbow Surg. 2019;28(8):1626-38. doi: 10.1016/j.jse.2018.12.017.
- 5. Akgül T, Zehir S, Özdemir G, et al.[The results of low profile locking anatomical plate application for the treatment of Edinburg type 2 clavicle diaphysis fractures]. Ulus Travma Acil Cerrahi Derg. 2014;20(4):286-90. doi: 10.5505/tjtes.2014.88303.
- 6. Hillen RJ, Burger BJ, Pöll RG, et al. The effect of experimental shortening of the clavicle on shoulder kinematics. Clin Biomech. 2012;27(8):777–81. doi: 10.1016/j.clinbiomech.2012.05.003.
- 7. Veeger HEJ, van der Helm FCT. Shoulder function: The perfect compromise between mobility and stability. J Biomech. 2007;40(10):2119-29. doi:10.1016/j.jbiomech.2006.10.016.
- 8. Nowak J, Holgersson M, Larsson S. Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg. 2004;13(5):479-86. doi: 10.1016/j.jse.2004.01.026.
- 9. Oroko PK, Buchan M, Winkler A, et al. Does shortening matter after clavicular fractures? Bull Hosp Jt Dis. 1999;58(1):6–8.
- 10. Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: The relevance of shortening and clinical outcome. J Shoulder Elbow Surg. 2006;15(2):191-4. doi: 10.1016/j.jse.2005.08.007.
- 11. Kennedy CA, Beaton DE, Smith P, et al. Measurement properties of the QuickDASH (disabilities of the arm, shoulder and hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review. Qual Life Res. 2013;22(9):2509-47. doi: 10.1007/s11136-013-0362-4.
- 12. Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res. 1981;155:7-20.
- 13. Conboy VB, Morris RW, Kiss J,et al. An evaluation of the constant-Murley shoulder assessment. J Bone Joint Surg. 1996;78-B:229-32.
- 14. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007;89:1-10. doi: 10.2106/JBJS.F.00020.
- 15. Virtanen KJ, Remes V, Pajarinen J, et al. Sling compared with plate osteosynthesis for treatment of displaced midshaft clavicular fractures: A randomized clinical trial. J Bone Joint Surg Am. 2012;94(17):1546-53. doi: 10.2106/JBJS.J.01999.
- 16. Woltz S, Krijnen P, Schipper IB. Mid-Term Patient Satisfaction and Residual Symptoms After Plate Fixation or Nonoperative Treatment for Displaced Midshaft Clavicular Fractures. J Orthop Trauma. 2018;32(11):e435-e439. doi: 10.1097/BOT.0000000000001269.
- 17. Figueiredo GSDL, Tamaoki MJS, Dragone B et al. Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function. BMC Musculoskelet Disord. 2015;16:151. doi: 10.1186/s12891-015-0585-3.
- 18. Malik A, Jazini E, Song X et al. Positional change in displacement of midshaft clavicle fractures: an aid to initial evaluation. J Orthop Trauma. 2017;31(1):e9-e12. doi: 10.1097/BOT.0000000000000727.
- 19. Cunningham BP, McLaren A, Richardson M, et al. Clavicular length: The assumption of symmetry. Orthopedics. 2013;36(3):e343-7. doi: 10.3928/01477447-20130222-24.
- 20. Omid R, Kidd C, Yi A, et al. Measurement of clavicle fracture shortening using computed tomography and chest radiography. Clin Orthop Surg. 2016;8(4):367-372. doi: 10.4055/cios.2016.8.4.367.
- 21. Stegeman SA, de Witte PB, Boonstra S et al. Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes. Acta Orthop. 2015;86(5):545-52. doi: 10.3109/17453674.2015.1040982.
- 22. Teubner E, Gerstenberger F, Burgert R. [kinematic consideration of the shoulder girdle and its consequences on common surgical methods]. Unfallchirurg. 1991;94(9):471-7.
- 23. Mullaji AB, Jupiter JB. Low-contact dynamic compression plating of the clavicle. Injury. 1994;25(1):41-5. doi: 10.1016/0020-1383(94)90183-x.
- 24 Özer M, Ataoğlu MB, Çetinkaya M, et al. Do intra-articular pathologies accompanying symptomatic acromioclavicular joint degeneration vary across age groups? Eklem Hastalik Cerrahisi. 2019;30(1):2-9. doi: 10.5606/ehc.2019.62431.
Comparison of Mid-term Functional Outcomes of Midshaft Clavicle Fractures: Conservative versus Surgical Treatment
Abstract
Abstract
Purpose: The aim of the present study was to compare the mid-term functional outcomes of midshaft clavicle fracture between surgical and conservative treatment methods.
Methods: Forty-six patients with a mean age of 33.9 years and a mean follow-up period of 62.1 months were treated open reduction and plate fixation (group 1), whereas 52 patients with a mean age of 32.1 years and a mean follow-up period of 58.7 months were treated conservatively (group 2) between January 2013 and January 2018. The conservative group divided into two groups (group 2A<2cm and group 2B ≥2 cm shortening). The shortening was calculated as the difference between the lengths of the two clavicles on bilateral clavicle anteroposterior (AP) radiograph at final visit. Functional evaluation was performed with the University of California at Los Angeles(UCLA) Shoulder score, Constant score, and Disabilities of the Arm, Shoulder and Hand(DASH) score.
Results:
No significant difference in age, gender, and follow-up duration was observed between two groups. The mean shortening in group 1 was 1.7 ± 0.4 mm(0-2.8). The mean shortening in group 2 was 14.8 ± 5.1 mm(7-24). There was no significant difference with respect to the DASH, Constant, and UCLA scores between two groups. However, there was a statistically significant difference between group A (<2 cm shortening) and group B (≥2 cm shortening) with respect to the DASH score.
Conclusions: DASH, UCLA, and Constant scores in the conservative group and the surgically treated group were similar in our study.
References
- 1. Su WR, Chen WL, Chen RH, et al. Evaluation of three-dimensional scapular kinematics and shoulder function in patients with short malunion of clavicle fractures. J Orthop Sci. 2016;21(6):739-44. doi:10.1016/j.jos.2016.07.005.
- 2. Ma X, Wang K, Ma J, et al. Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures. J Orthop Sci. 2020;25(2):310-4. doi: 10.1016/j.jos.2019.04.002.
- 3. Goudie EB, Clement ND, Murray IR et al. The Influence of Shortening on Clinical Outcome in Healed Displaced Midshaft Clavicular Fractures after Nonoperative Treatment. J Bone Joint Surg Am. 2017;99(14):1166-72. doi: 10.2106/JBJS.16.01010.
- 4. Malik SS, Tahir M, Jordan RW, et al. Is shortening of displaced midshaft clavicle fractures associated with inferior clinical outcomes following nonoperative management? A systematic review. J Shoulder Elbow Surg. 2019;28(8):1626-38. doi: 10.1016/j.jse.2018.12.017.
- 5. Akgül T, Zehir S, Özdemir G, et al.[The results of low profile locking anatomical plate application for the treatment of Edinburg type 2 clavicle diaphysis fractures]. Ulus Travma Acil Cerrahi Derg. 2014;20(4):286-90. doi: 10.5505/tjtes.2014.88303.
- 6. Hillen RJ, Burger BJ, Pöll RG, et al. The effect of experimental shortening of the clavicle on shoulder kinematics. Clin Biomech. 2012;27(8):777–81. doi: 10.1016/j.clinbiomech.2012.05.003.
- 7. Veeger HEJ, van der Helm FCT. Shoulder function: The perfect compromise between mobility and stability. J Biomech. 2007;40(10):2119-29. doi:10.1016/j.jbiomech.2006.10.016.
- 8. Nowak J, Holgersson M, Larsson S. Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg. 2004;13(5):479-86. doi: 10.1016/j.jse.2004.01.026.
- 9. Oroko PK, Buchan M, Winkler A, et al. Does shortening matter after clavicular fractures? Bull Hosp Jt Dis. 1999;58(1):6–8.
- 10. Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: The relevance of shortening and clinical outcome. J Shoulder Elbow Surg. 2006;15(2):191-4. doi: 10.1016/j.jse.2005.08.007.
- 11. Kennedy CA, Beaton DE, Smith P, et al. Measurement properties of the QuickDASH (disabilities of the arm, shoulder and hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review. Qual Life Res. 2013;22(9):2509-47. doi: 10.1007/s11136-013-0362-4.
- 12. Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res. 1981;155:7-20.
- 13. Conboy VB, Morris RW, Kiss J,et al. An evaluation of the constant-Murley shoulder assessment. J Bone Joint Surg. 1996;78-B:229-32.
- 14. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007;89:1-10. doi: 10.2106/JBJS.F.00020.
- 15. Virtanen KJ, Remes V, Pajarinen J, et al. Sling compared with plate osteosynthesis for treatment of displaced midshaft clavicular fractures: A randomized clinical trial. J Bone Joint Surg Am. 2012;94(17):1546-53. doi: 10.2106/JBJS.J.01999.
- 16. Woltz S, Krijnen P, Schipper IB. Mid-Term Patient Satisfaction and Residual Symptoms After Plate Fixation or Nonoperative Treatment for Displaced Midshaft Clavicular Fractures. J Orthop Trauma. 2018;32(11):e435-e439. doi: 10.1097/BOT.0000000000001269.
- 17. Figueiredo GSDL, Tamaoki MJS, Dragone B et al. Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function. BMC Musculoskelet Disord. 2015;16:151. doi: 10.1186/s12891-015-0585-3.
- 18. Malik A, Jazini E, Song X et al. Positional change in displacement of midshaft clavicle fractures: an aid to initial evaluation. J Orthop Trauma. 2017;31(1):e9-e12. doi: 10.1097/BOT.0000000000000727.
- 19. Cunningham BP, McLaren A, Richardson M, et al. Clavicular length: The assumption of symmetry. Orthopedics. 2013;36(3):e343-7. doi: 10.3928/01477447-20130222-24.
- 20. Omid R, Kidd C, Yi A, et al. Measurement of clavicle fracture shortening using computed tomography and chest radiography. Clin Orthop Surg. 2016;8(4):367-372. doi: 10.4055/cios.2016.8.4.367.
- 21. Stegeman SA, de Witte PB, Boonstra S et al. Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes. Acta Orthop. 2015;86(5):545-52. doi: 10.3109/17453674.2015.1040982.
- 22. Teubner E, Gerstenberger F, Burgert R. [kinematic consideration of the shoulder girdle and its consequences on common surgical methods]. Unfallchirurg. 1991;94(9):471-7.
- 23. Mullaji AB, Jupiter JB. Low-contact dynamic compression plating of the clavicle. Injury. 1994;25(1):41-5. doi: 10.1016/0020-1383(94)90183-x.
- 24 Özer M, Ataoğlu MB, Çetinkaya M, et al. Do intra-articular pathologies accompanying symptomatic acromioclavicular joint degeneration vary across age groups? Eklem Hastalik Cerrahisi. 2019;30(1):2-9. doi: 10.5606/ehc.2019.62431.
There are 24 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | October 14, 2021 |
| Publication Date | January 1, 2022 |
| Submission Date | August 9, 2021 |
| Published in Issue | Year 2022Volume: 13 Issue: 1 |
