Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: A randomized clinical trial

Ferran, Nicholas Antonio; Hodgson, P.; Vannet, Nicola; Williams, R. G.; Evans, Rhett

doi:10.1016/j.jse.2010.05.002

Cited by 156 publications

(160 citation statements)

References 14 publications

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“…Irrespective of the surgical treatment (plate versus intra-medullary fixation) the studies of Ferran et al, and Liu et al, could not draw significant difference in functional outcome [17,18]. But in the aspect of complications, titanium elastic nail showed superiority over plating.…”

Section: Author's Contributionsmentioning

confidence: 96%

Midshaft Clavicular Fracture and Titanium Elastic Intra-medullary Nail

Mishra

Gupta²,

Gaur

2014

JCDR

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Section: Author's Contributionsmentioning

confidence: 96%

Midshaft Clavicular Fracture and Titanium Elastic Intra-medullary Nail

Mishra

Gupta²,

Gaur

2014

JCDR

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“…Fifteen of these studies proved eligible for inclusion ( Figure 1). 5,10,[30][31][32][33][34][35][36][37][38][39][40][41][42] The overall agreement between the 2 reviewers for final eligibility was excellent (κ value = 0.94, 95% confidence interval [CI] 0.84-1). All 15 studies were published between 2007 and 2013; their characteristics are summarized in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…43 Five studies compared different operative implants. [37][38][39][40][41] One placebo-controlled trial managed all fractures nonoperatively. 42 Twelve studies were reported in English.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…5,10,[30][31][32][33][34][35][36][37]39,40 Eight studies were considered to be at low risk for attrition bias, 5,30,33,[35][36][37]40,42 6 were classified as high risk, 10,31,32,34,39,41 and 1 was judged as unclear. 38 Reporting bias was deemed high in 7 studies, 10,30,34,35,37,38,41 while 6 were unclear [31][32][33]39,40,42 and 2 were considered as low. 5,36 Agreement between reviewers in the assessment of methodologic quality was excellent (weighted κ value = 0.85).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Operative versus nonoperative interventions for common fractures of the clavicle: a meta-analysis of randomized controlled trials

et al. 2015

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C lavicle fractures are common injuries, affecting about 22 000 Canadians each year and numbering 1.75 million fractures worldwide. [1][2][3][4][5][6] The majority of these fractures are located in the midshaft, accounting for about 80% of all clavicle fractures.1,2 Closed midshaft fractures were traditionally treated nonoperatively, a practice largely based on previous studies by Neer and Rowe. 7,8 In the last decade, evidence challenged the standard of nonoperative treatment, reporting high rates of nonunion (15%-20%), poor early function, and residual sequelae at 6 months following nonoperative management in up to 42% of patients.9 Small clinical trials that followed have fuelled a growing popularity to treat these fractures surgically with plates and screws or intramedullary devices; however, these procedures carry inherent surgical risks for infection, implant failure and hardware irritation requiring subsequent removal. 10,11 Whether surgery or a conservative approach is the optimal method of management for midshaft clavicle fractures is still an issue of debate. Several trials have compared operative and nonoperative approaches to treatment. In the last 5 years, a number of trials have also investigated various surgical techniques and the use of different implants. Previous reviews focused only on the operative versus nonoperative debate. 1,9,11,12 Our review adds to this body of literature by providing data from the largest and most recent trial. It also provides a summary of the evidence on surgical techniques for these injuries, as well as nonsurgical options.We performed a meta-analysis to determine the effect of operative and nonoperative interventions for treating acute displaced midshaft clavicle fractures on the risk of secondary operation and all complications and on long-term function. Background: The popularity of surgery for acute displaced midshaft clavicle fractures has been fuelled by early randomized controlled trials (RCTs) showing improved rates of radiographic union and perceived functional benefits compared with nonoperative approaches. We performed a meta-analysis to determine the effect of operative and nonoperative interventions on the risk of secondary operation and complications and on long-term function. Operative versus nonoperative interventions for common

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“…Recently, there has been increasing interest in the operative treatment and plate fixation or intramedullary nailing is often the treatment modality of choice [4] . Numerous clinical studies, including many prospective, randomized controlled trials (RCTs), have been published to compare surgical and conservative treatments [5][6][7][8][9] . The best treatment for displaced midshaft clavicle fractures remains a topic of debate [10] .…”

Section: Introductionmentioning

confidence: 99%

Correlation of clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee

Sp¹,

Varma²,

Arya³

et al. 2017

Int. J. Orthop. Sci.

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Background: Clavicle fractures are common, with an overall incidence of 36.5 -64 per 100,000 people every year. Traditionally, midshaft clavicle fractures have been treated nonoperatively. Recently, there has been increasing interest in the operative treatment and plate fixation or intramedullary nailing is often the treatment modality of choice. Numerous clinical studies have been published to compare surgical and conservative treatments. The best treatment for displaced midshaft clavicle fractures remains a topic of debate. So We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Objectives: To compare functional outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Materials and Methods: 60 patients with a displaced midshaft fracture of the clavicle who were presented to RL Jalappa Hospital from June 2015 to October 2016 and either treated by conservative or operative methods of treatment and who were in regular follow up are selected. Functional assessment was done at 6 weeks, 3 months and 6 months with use of the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scores Complications, if any will be recorded. Results: DASH Scores and Constant scores were significantly better in the operative group compared to the conservative group at all time points. Conclusion: Operative treatment resulted in early return to function compared to conservative treatment but at the cost if complications like infection and other hardware related problems.

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Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: A randomized clinical trial

Cited by 156 publications

References 14 publications

Midshaft Clavicular Fracture and Titanium Elastic Intra-medullary Nail

Midshaft Clavicular Fracture and Titanium Elastic Intra-medullary Nail

Operative versus nonoperative interventions for common fractures of the clavicle: a meta-analysis of randomized controlled trials

Correlation of clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee

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