title: [Shortening deformities of the clavicle after diaphyseal clavicular fractures : Influence on patient-oriented assessment of shoulder function].
abstract: OBJECTIVE
  The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities.
  
  
  METHODS
  The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles.
  
  
  RESULTS
  Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001).
  
  
  CONCLUSIONS
  The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie, Eduardus-Krankenhaus, Custodisstr. 3-17, 50679, Köln, Deutschland. axeljubel@t-online.de.
authors.forename: A
authors.initials: A
authors.lastname: Jubel
authors.affiliation: Abteilung Unfallchirurgie, Handchirurgie und Orthopädie, Vinzenz Pallotti Hospital, Bergisch Gladbach, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Schiffer
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kreiskrankenhaus Mechernich GmbH, Mechernich, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Andermahr
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinikum Köln, Köln, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Ries
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinikum Köln, Köln, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Faymonville
mesh_terms: D000328:Adult; D002968:Clavicle / Q000002:abnormalities / Q000293:injuries* / Q000601:surgery*; D018483:Diaphyses / Q000293:injuries* / Q000601:surgery; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods; D012784:Shoulder Fractures / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Anatomical length; Clavicle score; Functional result; Patient-oriented assessment; Surgical treatment