A retrospective study of the association between shortening of the clavicle after fracture and the clinical outcome in 136 patients

TY - JOUR

T1 - A retrospective study of the association between shortening of the clavicle after fracture and the clinical outcome in 136 patients

AU - Rasmussen, Jeppe

AU - Jensen, Steen L

AU - Petersen, Jens

AU - Falstie-Jensen, Thomas

AU - Lausten, Gunnar

AU - Olsen, Bo S

N1 - Copyright © 2010 Elsevier Ltd. All rights reserved.

PY - 2011/4

Y1 - 2011/4

N2 - Background and purpose: The purpose of this retrospective study was to examine the association between shortening of the clavicle after a united midshaft fracture and clinical outcome. Second, the purpose was to compare the results obtained by conservative treatment with either a figure-of-eight bandage or a simple sling. Materials and methods: This study included 136 patients with a united, conservatively treated, midshaft clavicle fracture. Mean age was 35 years (range 15-70 years); mean follow-up time was 55 months (range 24-83 months). The shortening of the clavicle was measured on a radiograph including one antero-posterior view of both clavicles on a single film and defined as the difference between the injured and the contralateral clavicle. The clinical outcome was measured using the Constant-Murley Score. Results: The mean difference in the Constant-Murley Score between the injured and the contralateral shoulder was 7.3, P < 0.001 (95% confidence interval (CI) 5.6; 9.1). Mean shortening of the injured shoulder was 11.6 mm, P < 0.001 (95% CI 10.2; 13.0). A shortening of more than 20 mm was not associated with a poorer clinical outcome. The results obtained by conservative treatment with either a figure-of-eight bandage or a simple sling showed no difference in shortening or in the Constant-Murley Score. Conclusions: We found that conservative treatment of midshaft clavicle fractures resulted in final shortening and mild reduction of shoulder function. A shortening of 20 mm or more was not associated with a poorer clinical outcome. The figure-of-eight bandage and a simple sling were equal treatments of midshaft clavicle fractures.

AB - Background and purpose: The purpose of this retrospective study was to examine the association between shortening of the clavicle after a united midshaft fracture and clinical outcome. Second, the purpose was to compare the results obtained by conservative treatment with either a figure-of-eight bandage or a simple sling. Materials and methods: This study included 136 patients with a united, conservatively treated, midshaft clavicle fracture. Mean age was 35 years (range 15-70 years); mean follow-up time was 55 months (range 24-83 months). The shortening of the clavicle was measured on a radiograph including one antero-posterior view of both clavicles on a single film and defined as the difference between the injured and the contralateral clavicle. The clinical outcome was measured using the Constant-Murley Score. Results: The mean difference in the Constant-Murley Score between the injured and the contralateral shoulder was 7.3, P < 0.001 (95% confidence interval (CI) 5.6; 9.1). Mean shortening of the injured shoulder was 11.6 mm, P < 0.001 (95% CI 10.2; 13.0). A shortening of more than 20 mm was not associated with a poorer clinical outcome. The results obtained by conservative treatment with either a figure-of-eight bandage or a simple sling showed no difference in shortening or in the Constant-Murley Score. Conclusions: We found that conservative treatment of midshaft clavicle fractures resulted in final shortening and mild reduction of shoulder function. A shortening of 20 mm or more was not associated with a poorer clinical outcome. The figure-of-eight bandage and a simple sling were equal treatments of midshaft clavicle fractures.

U2 - 10.1016/j.injury.2010.11.061

DO - 10.1016/j.injury.2010.11.061

M3 - Journal article

SN - 0020-1383

VL - 42

SP - 414

EP - 417

JO - Injury

JF - Injury

IS - 4

ER -