What is the efficacy of surgery of group I clavicle fractures?

Updated: Jan 14, 2019
  • Author: Benjamin P Kleinhenz, MD; Chief Editor: Craig C Young, MD  more...
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Evidence is mounting, however, in support of operative treatment for displaced midshaft clavicle fractures. A prospective, multicenter, randomized trial by the Canadian Orthopaedic Trauma Society found that operative repair for these injuries provided better results than did nonoperative treatment. In the study, involving 132 patients with a displaced midshaft fracture, outcome and complication rates were compared for nonoperative treatment and plate fixation. [33]

The investigators determined that mean time to radiographic union was significantly shorter in the operative group (16.4 wk vs 28.4 wk). Additionally, functional outcomes were improved at all time points measured in the operative group. This study provided level I evidence in support of plate fixation for completely displaced midshaft clavicle fractures in the active adult population. [33]

Similarly, a study by Smekal et al found better results with another operative procedure, elastic stable intramedullary nailing (ESIN), than with nonoperative treatment in the repair of fully displaced midshaft clavicle fractures. Outcomes with regard to the rate of successful bone union, functional outcome, time required for patients to resume their daily activities, and overall patient satisfaction were superior in the operative group than in nonoperative patients. There was also significantly less posttraumatic clavicular shortening in the surgical group.

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