title: Evaluation of surgical and non-surgical interventions for clavicle fractures.
abstract: OBJECTIVE
  The aim of this study was to review all systematic reviews and meta-analyses and provide an overview of the evidence of efficacy of interventions for clavicle fractures.
  
  
  METHODS
  The Cochrane Library, PubMed, MEDLINE, Chinese Biomedicine database, China Academic Journals Full-text Database, VIP Chinese Science and Technology Periodicals Database and Wanfang Database were searched for eligible studies using keywords related to clavicle fractures. The methodological quality of included studies was assessed using the AMSTAR assessment tool. Direct evidence was analyzed narratively. Randomized controlled trials were pooled again for meta-analysis. The GRADE approach was used in summary conclusions.
  
  
  RESULTS
  The result of pooled data showed that while operative treatment had lower nonunion and malunion rates and higher patient satisfaction than non-operative treatment modalities [RR=6.57, 95% CI (3.01, 14.35), RR=6.93, 95% CI (2.99, 16.09); RR=0.68, 95% CI (0.51, 0.90)], these 3 outcomes were based on low-quality evidence. There was no difference between dissimilar operative and dissimilar non-operative treatments.
  
  
  CONCLUSIONS
  Operative treatment is more effective than non-operative treatment in terms of nonunion and malunion rates and patient satisfaction. As the quality of evidence comparing efficacy between intervention methods is generally low, further original studies are needed.
authors.affiliation: The First Clinical Medicine College of Lanzhou University, Lanzhou, Gansu, China; The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Shengping
authors.initials: S
authors.lastname: Yang
authors.affiliation: Shanghai Medical College of Fudan University, Shanghai, China; Liver Cancer Institute, Zhongshan Hospital, Shanghai, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhang
authors.affiliation: The First Clinical Medicine College of Lanzhou University, Lanzhou, Gansu, China; The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Qingling
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: The First Clinical Medicine College of Lanzhou University, Lanzhou, Gansu, China; The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Guan
authors.initials: G
authors.lastname: Wang
authors.affiliation: The First Clinical Medicine College of Lanzhou University, Lanzhou, Gansu, China; The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Xuanxi
authors.initials: X
authors.lastname: Ding
authors.affiliation: The First Clinical Medicine College of Lanzhou University, Lanzhou, Gansu, China; The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Wang
mesh_terms: D001458:Bandages; D002968:Clavicle / Q000293:injuries*; D019317:Evidence-Based Medicine; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery* / Q000628:therapy; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D013165:Splints; D016896:Treatment Outcome