Skip to main content

21.06.2017 | Orthopaedic Surgery | Ausgabe 8/2017 Open Access

Archives of Orthopaedic and Trauma Surgery 8/2017

Does clavicular shortening after nonoperative treatment of midshaft fractures affect shoulder function? A systematic review

Archives of Orthopaedic and Trauma Surgery > Ausgabe 8/2017
Sarah Woltz, Alysia Sengab, Pieta Krijnen, Inger B. Schipper
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00402-017-2734-7) contains supplementary material, which is available to authorized users.
Sarah Woltz and Alysia Sengab shared first authorship.



Clavicular shortening due to non-anatomical healing of displaced clavicular fractures is believed to have a negative effect on shoulder function after recovery. The evidence for this, however, is equivocal. This review aimed to systematically evaluate the available literature to determine whether the current beliefs about clavicular shortening can be substantiated.

Materials and methods

This systematic review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. PubMed, EMBASE, Web of Science and the Clinical Trial Registry were searched to identify all studies published in English that evaluated the association between clavicular shortening and shoulder function in patients aged ≥16 years with a nonoperatively treated, displaced midshaft clavicular fracture. Relevant data from the selected studies was extracted and summarized. Risk of bias of the included studies was assessed using the MINORS instrument.


Six studies, of which five were retrospective, were included in this review analyzing a total of 379 patients. Due to heterogeneity in methods and reporting across studies, a pooled analysis of the results was not feasible. No clear associations were found between shortening and shoulder function scores (DASH and Constant score) or arm strength in each of the included studies.


The existing evidence to date does not allow for a valid conclusion regarding the influence of shortening on shoulder function after union of nonoperatively treated midshaft clavicular fractures. Shortening alone is currently not an evidence-based indication to operate for the goal of functional improvement. Well-powered prospective comparative studies are needed to draw firm conclusions.

Unsere Produktempfehlungen

e.Med Interdisziplinär


Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

e.Med Orthopädie & Unfallchirurgie


Mit e.Med Orthopädie & Unfallchirurgie erhalten Sie Zugang zu CME-Fortbildungen der Fachgebiete, den Premium-Inhalten der dazugehörigen Fachzeitschriften, inklusive einer gedruckten Zeitschrift Ihrer Wahl.

Supplementary material 1 (DOCX 12 kb)
Über diesen Artikel

Weitere Artikel der Ausgabe 8/2017

Archives of Orthopaedic and Trauma Surgery 8/2017 Zur Ausgabe

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.