Comparison of Mid-term Functional Outcomes of Midshaft Clavicle Fractures: Conservative versus Surgical Treatment

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.