Clinical and financial comparison of operative and nonoperative treatment of displaced clavicle fractures

Translation, cross-cultural adaptation and validation of the Italian version of the Nottingham Clavicle Score (NCS)

“…The inclusion of this item may tend to give misleading results, while cosmetic satisfaction can vary greatly from patient to patient. However, the literature suggests that improved cosmetic satisfaction is one of the main benefits from operative management of ACJ dislocation and clavicle fractures [15,16]. Therefore, the cosmetic satisfaction question can be a useful tool in deciding whether a patient will receive conservative or operative treatment based on how the patient perceives the appearance of their shoulder [4].…”

A Cost Analysis of Internal Fixation Versus Nonoperative Treatment in Adult Midshaft Clavicle Fractures Using Multiple Randomized Controlled Trials

“…What is not accounted for in this analysis is the cost to the patients as performed by Althausen et al 15 Are the improved functional scores and decreased time to union worth the additional cost to the payer to have them return to work and contribute as productive members of society? What is not accounted for in this analysis is the cost to the patients as performed by Althausen et al 15 Are the improved functional scores and decreased time to union worth the additional cost to the payer to have them return to work and contribute as productive members of society?…”

“…[9][10][11][12] Multiple randomized controlled trials (RCTs) have been published comparing operative with nonoperative treatment in terms of functional outcomes with Constant and DASH scores 13,14 and rates of complications, such as nonunion, symptomatic malunion, which favor initial operative stabilization in the short term. 15 Because no clear consensus is available based on review of the large volume of literature available, 16 surgeons are faced with difficult decisions on how best to treat adults with displaced midshaft clavicle fractures. 15 Because no clear consensus is available based on review of the large volume of literature available, 16 surgeons are faced with difficult decisions on how best to treat adults with displaced midshaft clavicle fractures.…”

Plain film measurement error in acute displaced midshaft clavicle fractures

“…23,24 However, emerging evidence suggests that the risks of surgical treatment may be outweighed by functional and financial benefits for patients with midshaft clavicle fractures shortened 20 mm or more. 3,13,11,25 In the 1960s, Rowe and colleagues 23 and Neer and colleagues 24 conducted large clinical series (566 patients and 2235 patients, respectively) documenting outcomes of patients with clavicle fractures treated nonoperatively. These studies independently reported nonunion rates less than 1% and failed to identify functional compromise with nonoperative treatment.…”