title: Factors Affecting Functional Outcomes After Clavicle Fracture.
abstract: BACKGROUND
  This study evaluated the effects that patient demographics, injury, and social characteristics have on functional outcomes after clavicle fracture.
  
  
  METHODS
  After a mean follow-up of 56 months, 214 patients with a mean age of 44.4 years completed the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The effects that age, sex, fracture location, open fracture, associated injuries, tobacco use, employment status, and timing of surgery had on functional outcomes were assessed.
  
  
  RESULTS
  The mean ASES score for the entire group of 214 patients was 80.5. Seventy-seven patients (36%) were treated surgically and 137 patients (64%) were treated nonsurgically. The mean ASES scores were 84.0 and 78.5, respectively, in the surgical and nonsurgical groups (P = 0.06). Patients with lateral fractures who were treated surgically had better ASES scores than those treated nonsurgically (91.3 versus 72.7, P = 0.011); this was also true of patients with isolated fractures (P = 0.02). Smokers in the surgical and nonsurgical groups had scores of 74.1 and 83.6, respectively (P = 0.003). Patients who were unemployed had the worst ASES scores regardless of surgical or nonsurgical treatment (70.5 and 86.1, respectively; P < 0.001). Surgical timing was not related to outcome; no difference in ASES scores was noted in patients treated surgically within ≤10 weeks versus those treated after 10 weeks after injury and in those treated within <20 weeks versus those treated >20 weeks after injury (both, P > 0.34).
  
  
  CONCLUSIONS
  We identified factors associated with better functional outcomes, which could aid in developing treatment recommendations. Additionally, initial nonsurgical management of clavicle fractures may be reasonable because patients had similar functional outcomes even when surgery was delayed.
  
  
  METHODS
  Level III retrospective comparative study.
authors: From the Department of Orthopaedic Surgery, The MetroHealth System and Case Western Reserve University, Cleveland, OH.
authors: Joshua K
authors: JK
authors: Napora
authors: Dominic
authors: D
authors: Grimberg
authors: Benjamin R
authors: BR
authors: Childs
authors: Heather A
authors: HA
authors: Vallier
mesh_terms: D000328:Adult; D002968:Clavicle / Q000293:injuries*; D005260:Female; D017102:Fracture Healing; D050723:Fractures, Bone / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome