The Comparison of Results of Treatment of Midshaft Clavicle Fracture between Operative Treatment with Plate and Non-Operative Treatment.
BACKGROUND
Clavicle fractures are common and usually heal without complications. In this study, we evaluated the outcomes of non-operative versus operative management of displaced fractures.


METHODS
In a prospective clinical trial study, sixty-five patients with displaced clavicle mid-shaft fractures were non-randomly divided in two treatment groups. The first group underwent non-operative treatment with figure of 8 bandage (30 patients), and the other underwent operative treatment with plate fixation (35 patients). Figure of 8 bandage and 3.5 millimeter DCP plate with at least six cortical screws were used in non-operative and operative groups respectively. We followed up all patients at weeks 2, 6 and 12, and at month sixth. In addition to clinical examination and x-ray evaluation, we assessed satisfaction, DASH and Constant Shoulder Score for each individual.


RESULTS
The average durations of union were 19.3 and 24.4 weeks in operative and non-operative groups respectively (P=0.006). Satisfaction with operative treatment was 74.3% and with non-operative treatment was 66.7%, showing no significant difference (P=0.500). The non-union rate was 5.7% in the operative group and 13.3% in the non-operative group (P=0.518). A significant difference between the two groups in terms of DASH and Constant Shoulder Scores after the six-month follow-up was not found (P=0.352).


CONCLUSIONS
According to our results, we recommend operative treatment in mid-shaft clavicle fractures only when there is a definitive indication.
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Mohsen
M
Khorami
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Mohammad
M
Fakour
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Hossein
H
Mokarrami
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Hamid Reza
HR
Arti
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Abdolhossein Mahdi
AM
Nasab
Mohsen Khorami MD, Hamid Reza Arti MD, Golestan Hospital, Joundishapour University of Medical Sciences, Ahvaz, Iran.
Farid
F
Shahrivar
Clavicle; Constant Shoulder Score; DASH score; Internal fixation; Non-operative management