title: External fixators in the treatment of midshaft clavicle non-unions: a systematic review.
abstract: Non- or mal-union of the clavicle is reported to occur in up to 15 % of conservatively treated fractures: the purpose of this systematic review is to examine the evidence for the use of external fixation in the treatment of clavicular non-union. We performed a search of MEDLINE and Embase, including all papers using external fixators for the treatment of clavicular non-union. Four papers satisfied our eligibility criteria: three case series and one case-control study. Level of evidence and quality assessment scoring were performed using published methods. Due to the heterogeneity of the study populations and interventions, no attempt at meta-analysis was made. External fixation in hypertrophic non-union of the clavicle, but not atrophic non-union, appears to be a reasonable treatment option. A pragmatic, multicentre, randomised controlled trial comparing external fixation and open reduction internal fixation in the treatment of hypertrophic non-union of the clavicle would be valuable.
authors: Department of Trauma and Orthopaedics, University of Warwick, Coventry, UK, timbarlow1@hotmail.com.
authors: Tim
authors: T
authors: Barlow
authors: Piyush
authors: P
authors: Upadhyay
authors: David
authors: D
authors: Barlow
mesh_terms: D002968:Clavicle / Q000293:injuries / Q000601:surgery*; D016267:External Fixators / Q000706:statistics & numerical data*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome