title: Return to athletic activity after plate fixation of displaced midshaft clavicle fractures.
abstract: BACKGROUND
  Recent data support primary plate fixation of displaced midshaft clavicle fractures. The safety and efficacy of this practice have not been well documented in athletes.
  
  
  OBJECTIVE
  Plate fixation of clavicle fractures in athletes is a safe and effective procedure, resulting in a reliable and timely return to play.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  A total of 29 patients with displaced midshaft clavicle fractures from athletic activity were treated with plate fixation between January 1, 2003 and December 31, 2008, including 1 patient treated for each clavicle for separate injuries. All 29 patients were contacted for follow-up. At a mean follow-up of 21 months, patients completed a questionnaire focused on the time to return to athletics and treatment course. Patients also completed the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Radiographs were reviewed to identify fracture comminution, displacement, shortening, and angulation; radiographic union time; and malunion.
  
  
  RESULTS
  All of the patients (30/30 cases) returned to sports after open reduction internal fixation of their fracture. The mean time to return to play was 83 days with a range of 13 to 277 days. Seven (23%) of the cases returned to athletics at ≤6 weeks after surgery, and a total of 20 patients (67%) returned at ≤12 weeks after surgery. All patients (100%) were satisfied with their treatment. The QuickDASH scores revealed almost perfect recovery (mean score, 0.8 of 100). Four minor complications were identified. No patient had a refracture, plate fracture, loss of fixation, nonunion, malunion, or deep wound infection.
  
  
  CONCLUSIONS
  Plate fixation of displaced clavicle fractures in athletes is a safe procedure, resulting in a high satisfaction rating and minimal disability to the upper extremity. An early return (<6 weeks) to sports is possible after this treatment; however, the time to return is highly variable.
authors: Glenn S. Fleisig, American Sports Medicine Institute, 833 St Vincent's Drive, Suite 100, Birmingham, AL 35205. glennf@asmi.org.
authors: Steven W
authors: SW
authors: Meisterling
authors: E Lyle
authors: EL
authors: Cain
authors: Glenn S
authors: GS
authors: Fleisig
authors: Jeffrey L
authors: JL
authors: Hartzell
authors: Jeffrey R
authors: JR
authors: Dugas
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000601:surgery*; D001860:Bone Plates; D002648:Child; D002968:Clavicle / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: QuickDASH; football (American); high school; open reduction internal fixation; radiographic union; shoulder