A New Classification System for Outcome Measurements of Mid-Clavicular Fractures

Abstract

Purpose: The current investigation was designed to evaluate and validate a simple assessment system focusing on outcomes on clavicle fractures. Method: To examine the new scoring system focusing on outcomes post-midclavicular fracture and lateral clavicle fractures, 312 patients were studied on average 17 months post-injury. The cohort included 33 patients with lateral clavicle fractures, 46 non unions after midclavicular fracture and 233 patients with midclavicular fractures. As a control group, the same parameters in 45 healthy volunteers were examined. The Cologne Clavicle Score (CCS) is based on a system of three partnered objective/subjective items as well as radiographic assessment of fracture healing. To validate the system, linear regression analysis was performed comparing the Cologne Clavicle Score to two established assessment systems (Score of Constant and Murley and the DASH Score). Results: The correlation coefficients R=0.756 (Constant) and R=0.687 (DASH) post midclavicular fractures and R=0.780 (Constant and DASH) post lateral clavicle fractures indicated that the conclusions were comparable to two established assessment systems and therefore valid. The reliability coefficient Cronbach’s Alpha was calculated at 0.8324, indicating high reliability. Conclusion: The CCS is a simple, valid, and reliable instrument to assess outcomes post-midclavicular fracture and lateral clavicle fractures. It needs application in further studies to fully evaluate the quality of its conclusions.