Operative versus non-operative treatment for clavicle fracture: a meta-analysis

Liu, Guodong; Tong, Songlin; Ou, Shan; Zhou, Lei; Fei, Jun; Guo, Nan; J, Gu

doi:10.1007/s00264-013-1871-z

Cited by 34 publications

(26 citation statements)

References 20 publications

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“…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.…”

mentioning

confidence: 99%

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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confidence: 99%

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

et al. 2015

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“…5,8,9,17 In a prospective, randomized study, Robinson et al 15 Also, radiologic signs of fracture healing on CT scan were present in a higher rate in the S group. At final followup, 9.6% of nonunion cases were found in the C group and no cases in the S group.…”

Section: Discussionmentioning

confidence: 97%

Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population

Meleán

Zuniga

Marsalli

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…[17][18][19][20][21][22][23][24][25][26][27][28][29][30] Hill et al 17 and McKee et al 28 have reported shoulder dysfunction with shortening of 20 mm or more. However, Nordqvist et al [29][30][31] have reported no clinical significance of shortening on function of shoulder and patient accepts angulations as well as residual bone prominence.…”

Section: Figure 6 a 56 Years Male Accepted Malunion And Cosmetic Dementioning

confidence: 99%

Conservative Versus Operative Treatment of Displaced Mid Shaft Clavicle Fracture- A Two Years Randomized Controlled Study

Kumar¹,

Gulati²

2018

jebmh

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BACKGROUNDClavicle fractures were considered non-troubling entity in the past. Majority of mid shaft fractures used to be treated conservatively and many studies reported relatively good results. However, more recent studies have reported poor results following conservative treatment regarding non-union, disabilities and cosmetic reasons. Surgeons in the past use to fix clavicle fractures with pins, simple plates and external fixators having high failure rates. Whereas the results of operative treatment improved considerably with introduction of better implants and awareness regarding disability specially among young people and sports persons. The aim of this study was to compare results of closed versus operative treatment.

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Operative versus non-operative treatment for clavicle fracture: a meta-analysis

Abstract: Operative treatment is better than non-operative treatment, but decisions should be made in accordance with specific conditions for clinical application.

Cited by 34 publications

References 20 publications

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

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

Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population

Conservative Versus Operative Treatment of Displaced Mid Shaft Clavicle Fracture- A Two Years Randomized Controlled Study

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