This meta-analysis of high-quality studies showed that surgical treatment of MCFs results in fewer nonunions, fewer malunions, and an accelerated return to work compared with nonsurgical treatment. A meta-analysis of surgical treatments need not be restricted to randomized trials, provided that the included observational studies are of high quality.

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BackgroundFractures of the proximal humerus are common and most often treated non-operatively. However, long-term follow-up studies focusing on functional results and quality of life in patients after this type of fracture are scarce. The primary aim of this study is to report the long-term functional and quality of life outcome in patients with a proximal humeral fracture.Materials and methodsA retrospective analysis of all consecutive patients undergoing non-operative treatment for a proximal humeral fracture in a level 2 trauma centre between January 2000 and December 2013 was performed. A database consisting of all relevant demographic, patient and fracture characteristics was created. Subsequently, a questionnaire containing the DASH (Disabilities of the Arm, Shoulder and Hand) score, EuroQol-5D (EQ-5D), VAS (visual analogue scale) score, and subjective questions was sent to all patients.ResultsA total of 410 patients (65 male, 345 female) were included for analyses. Average follow-up was 90 ± 48 months. DASH-scores <15 were considered as good. A median DASH-score of 6.67 [0.83–22.50] was found. A significant lower DASH-score was seen in patients under the age of 65 compared to older patients (p < 0.001). In comparison to an age-matched general Dutch population, Health related Quality of Life (HrQoL) on the EQ-us was not significantly worse in our study population (difference 0.02). Strong (negative) correlation was found between DASH-score and VAS-score, and DASH-score and HrQoL, respectively ρ = −0.534 and ρ = −0.787.ConclusionLong-term functional and quality of life outcomes are good in most patients after proximal humeral fractures, but negatively correlated to each other.Level of evidenceLevel III.

Plate fixation for cyclists with displaced clavicle fractures was successful in terms of fast return to previous level of athletic activity. It is a valuable and safe option for athletes in cycling.

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Clavicle (n.) or "collarbone" originates in 1610s, middle French clavicule also "small key" from clavicula (used c. 980 in a translation Avicenna), which means tendril, door-bolt, or small key. Derived form the Latin word clavicula (a little key, key; vinetendril; pivot). The earliest know usage of clavicle in English dates from the 17 th century. The bone rotates along its axis like a key when the shoulder is abducted and it is roughly the same shape as key from a Roman door lock. 1 This refers to the anatomical structure including the s-shape of the bone and the "key" connection of the sternum with the shoulder girdle. The clavicle articulates at one end with the sternum and with the acromion of the scapula at the other, making it the only bony connection between the trunk and the upper limb.

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