The authors declare that they have no competing interests.
GSLF made important contributions in the preparation and design of the present study, participated in the patients follow-up, reviewed the bibliography for references and performed the statistical analysis; MJST participated collecting information on patient follow-up, measured the radiographs, designed and prepared the study and made statistical analysis; BD participated collecting information, made statistical analysis and reviewed the bibliography; NAN participated in pacients follow-up, radiographics analysis and discussed the results; MHM participated in pacients follow-up, radiographics analysis, made statistical analysis; FTM participated in the translation of study, statistical analysis and designing the study; AYU participated in the study design and preparation and statistical analysis and reviewed the bibliography. All authors read and approved the final manuscript.
Despite the use of non-surgical methods to treat for the majority of midshaft fractures of the clavicle, it is remains controversial whether shortening of this bone following non-surgical treatment of a middle third fracture affects upper limb function.
We conducted a cohort study by sequentially recruiting 59 patients with a fracture of the middle third of the clavicle. All patients were treated nonsurgically with a figure-of-eight bandage until clinical and radiological findings indicated healing of the fracture. Functional outcome was assessed using the Disability of Arm, Hand and Shoulder (DASH) score revalidated for the Portuguese language, other outcomes assessed included: pain measured by visual analogue scale (VAS); radiographies to measure the degree of shortening, fracture consolidation and fracture malunion. Information were also collected regarding the mechanism of injury, patient’s daily activities level and epidemiological features of the patient cohort. The results of our findings are expressed as the comparison of the functional outcome with the degree of shortening.
Patients were assessed six weeks and one year after injury. In the first evaluation, the mean DASH score was 28.84 and pain measured by VAS was 2.57. In the second evaluation (one year after injury) the mean DASH score was 8.18 and pain was 0.84. The mean clavicle shortening was 0.92 cm, ranging from 0 to 3 cm (SD = 0.64). There were no correlation between the degree of shortening and DASH score after six weeks and one year (p = 0.073 and 0.706, respectively). When only patients with of shortening greater than 2 cm were assessed for correlation, the result did not change.
We conclude that clavicle shortening after nonsurgical treatment with a figure-of-eight bandage does not affect limb function, even when shortening exceeds 2 cm.
ISRCTN85206617. Registered 12 May 2014
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- Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function
Gustavo Santiago de Lima Figueiredo
Marcel Jun Sugawara Tamaoki
Artur Yudi Utino
Nicola Archetti Netto
Marcelo Hide Matsumoto
Fábio Teruo Matsunaga
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
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