title: Clinical outcome and radiographic change of ipsilateral scapular neck and clavicular shaft fracture: comparison of operation and conservative treatment.
abstract: OBJECTIVE
  The purpose of this study is to compare glenopolar angle (GPA) and the functional outcomes of fixation of both the clavicle and the scapular neck, fixation of the clavicle alone, and conservative treatment for floating-shoulder injuries.
  
  
  METHODS
  A prospective stratified randomized study was performed in 39 adult patients who suffered floating-shoulder injuries and underwent fixation of both the clavicle and the scapular neck (group A), or fixation of the clavicle alone (group B), or conservative treatment (group C) between January 2005 and September 2011. The GPA, Disabilities of the Arm, Shoulder and Hand (DASH) score, and Constant-Murley Shoulder Outcome (Constant) score were compared between the three groups.
  
  
  RESULTS
  All 39 patients were followed up for more than 2 years. GPA after bony consolidation was significantly better in group A than in groups B and C (p = 0.015). Functional outcomes measured by DASH and Constant scores were significantly better in group A at final follow-up (p = 0.008 and 0.002, respectively). Both DASH and Constant scores were highly correlated with GPA after consolidation (p < 0.001, respectively). The receiver operating characteristic (ROC) analysis showed that of the two randomly selected DASH scores, the smaller DASH score would have a larger GPA than the larger DASH score. Similarly, the larger Constant score would have a larger GPA than the smaller Constant score.
  
  
  CONCLUSIONS
  Fixation of both the clavicle and the scapular neck may correct GPA and improve functional outcomes for the treatment of floating-shoulder injuries. GPA after fracture consolidation is a useful prognostic indicator of a satisfactory clinical outcome as defined by either DASH score or Constant score.
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. alilin422@yahoo.com.tw.
authors: Tsung-Li
authors: TL
authors: Lin
authors: Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan. yufenli@mail.cmu.edu.tw.
authors: Yu-Fen
authors: YF
authors: Li
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. d5983@mail.cmuh.org.tw.|School of Chinese Medicine, China Medical University, China Medical University Hospital, Taichung, Taiwan. d5983@mail.cmuh.org.tw.
authors: Chin-Jung
authors: CJ
authors: Hsu
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. aaa670223@yahoo.com.tw.
authors: Chih-Hung
authors: CH
authors: Hung
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. d21476@mail.cmuh.org.tw.
authors: Chi-Chang
authors: CC
authors: Lin
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. d1762@mail.cmuh.org.tw.|School of Chinese Medicine, China Medical University, China Medical University Hospital, Taichung, Taiwan. d1762@mail.cmuh.org.tw.
authors: Yi-Chin
authors: YC
authors: Fong
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. d4749@mail.cmuh.org.tw.|Graduate Institute of Clinical Medical Science, School of Medicine, China Medical University, Taichung, Taiwan. d4749@mail.cmuh.org.tw.
authors: Horng-Chaung
authors: HC
authors: Hsu
authors: Department of Orthopedic Surgery, China Medical University Hospital, #2 Yue-Der Road, Taichung, 40447, Taiwan. ritsai8615@gmail.com.|Graduate Institute of Clinical Medical Science, School of Medicine, China Medical University, Taichung, Taiwan. ritsai8615@gmail.com.
authors: Chun-Hao
authors: CH
authors: Tsai
mesh_terms: D000328:Adult; D002968:Clavicle / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012540:Scapula / Q000293:injuries*; D016896:Treatment Outcome; D055815:Young Adult
references: Arch Orthop Trauma Surg. 2001 Jun;121(6):313-6
references: 11482461
references: J Shoulder Elbow Surg. 2005 Nov-Dec;14(6):585-90
references: 16337524
references: J Orthop Trauma. 1993;7(2):99-106
references: 8459301
references: BMC Musculoskelet Disord. 2011;12:196
references: 21864352
references: J Bone Joint Surg Am. 2001 Aug;83-A(8):1188-94
references: 11507127
references: Clin Orthop Relat Res. 2011 Dec;469(12):3390-9
references: 21761253
references: Injury. 2012 Mar;43(3):327-33
references: 22036452
references: Clin Orthop Relat Res. 1987 Jan;(214):160-4
references: 3791738
references: J Shoulder Elbow Surg. 2003 Nov-Dec;12(6):589-91
references: 14671523
references: J Trauma Acute Care Surg. 2012 Feb;72(2):E8-13
references: 22439229
references: Stat Med. 2006 Feb 15;25(3):481-93
references: 16287217
references: J Bone Joint Surg Br. 2006 Nov;88(11):1419-24
references: 17075083
references: Singapore Med J. 2000 Sep;41(9):452-3
references: 11193118
references: Injury. 2005 Oct;36(10):1176-81
references: 16054146
references: J Trauma. 2008 Jan;64(1):174-8
references: 18188118
references: J Bone Joint Surg Am. 1993 Jul;75(7):1015-8
references: 8335660
references: J Bone Joint Surg Br. 2001 Aug;83(6):795-8
references: 11521916
references: Int Orthop. 2002;26(3):145-9
references: 12073105
references: J Bone Joint Surg Am. 2000 Jun;82(6):774-80
references: 10859096
references: J Bone Joint Surg Br. 1992 May;74(3):362-4
references: 1587877
references: Am J Ind Med. 1996 Jun;29(6):602-8
references: 8773720
references: Clin Biomech (Bristol, Avon). 2004 Nov;19(9):906-12
references: 15475122
references: J Am Acad Orthop Surg. 1995 Jan;3(1):22-33
references: 10790650
references: J Orthop Trauma. 1995 Apr;9(2):93-7
references: 7776042