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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer Berlin Heidelberg

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DOI

10.1007/s00414-013-0953-1

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ISSN

1434-3916

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Radiological and functional outcomes 27 years fol

Authors: Hendrik F S Fuglesang Gunnar B Flugsrud PerHenrik Randsborg Knut Stavem Stein E Utvåg
Publish Date: 2015/11/04
Volume: 136, Issue: 1, Pages: 17-25
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Abstract

It is unclear whether all completely displaced midshaft clavicle fractures require primary surgical intervention The aim of this study was to elucidate the radiological and clinical outcomes after conservative treatment and to identify subgroups at risk of an inferior outcomeBetween 2005 and 2008 122 patients were conservatively treated for a completely displaced midshaft clavicle fracture of whom 92 were eligible for inclusion in this study Of these 59 completed the study after a median of 27 years after the fracture min–max 11–49Nonunion was found in 9 of the 59 153  patients Twentyfour 24  patients reported a fairtopoor DASH score ie 20 Patients with fractures that were vertically displaced by more than 100  one bone width were significantly less satisfied than those with fractures vertically displaced at 100  p = 004 Initial shortening of more than 15 mm was not associated with a worse outcome or nonunion The odds ratio of developing a nonunion increased with age p = 004By treating completely displaced midshaft clavicle fractures conservatively with a sling and offering plate fixation for eventual painful nonunions we found a 24  risk of a fair or poor clinical result with a DASH score over 20 A vertical displacement of more than 100  between the main fragments on the initial radiograph was associated with an inferior clinical outcome in this studyDr Fuglesang has received funding from Akershus University Hospital and from the Sophies Minde foundation This funding also paid for radiographs No other authors received any financial support for this study We are grateful for the cooperation from Dr Hasan Banitalebi Department of Radiology Akershus University Hospital

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