Minimal early functional gains after operative treatment of midshaft clavicular fractures : a meta-analysis of 10 randomized controlled trials including 1333 patients

© 2024 The Authors.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 8(2024), 3 vom: 15. Mai, Seite 400-406
1. Verfasser: Qvist, Andreas H (VerfasserIn)
Weitere Verfasser: Jensen, Steen L
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Review Clavicle fracture Functional outcomes Non-operative Operative Patient reported outcome measures Recovery
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245 1 0 |a Minimal early functional gains after operative treatment of midshaft clavicular fractures  |b a meta-analysis of 10 randomized controlled trials including 1333 patients 
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520 |a Background: There is substantial evidence that operative treatment reduces the risk of nonunion but offers no long-term functional gains compared with nonoperative treatment. Despite some studies citing quicker recovery with surgery, the promise of accelerated functional recovery remains under-investigated. The aim of this meta-analysis of randomized controlled trials was to investigate the possible early functional gains (≤6 months) after operative treatment of displaced midshaft clavicular fractures compared with nonsurgical treatment 
520 |a Methods: A systematic search was performed to identify randomized controlled trials comparing plate osteosynthesis with nonoperative treatment. We evaluated shoulder function outcomes measured by Constant Score or Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Other outcomes of interest were sick leave and return to previous activity (work, leisure) 
520 |a Results: Ten studies including 1333 patients were included. The mean difference in DASH score after 6 weeks was 9.4 points (95% confidence interval [CI] 13.7-5.1) in favor of operative treatment. At 3 months, the difference was 3.6 points (95% CI 6.9-0.4), and at 6 months, the difference was 3.2 points (95% CI 5.2-1.1), both in favor of operative treatment. Results for Constant Score were similar to that of DASH score 
520 |a Conclusion: This meta-analysis shows that there is an early functional gain at six weeks following plate fixation of midshaft clavicular fractures compared with nonoperative treatment. At three and six months, the functional gain is lesser and not clinically relevant 
650 4 |a Journal Article 
650 4 |a Review 
650 4 |a Clavicle fracture 
650 4 |a Functional outcomes 
650 4 |a Non-operative 
650 4 |a Operative 
650 4 |a Patient reported outcome measures 
650 4 |a Recovery 
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