Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures
OBJECTIVES:Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before uni...
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| Veröffentlicht in: | Journal of orthopaedic trauma 2014-03, Vol.28 (3), p.119-123 |
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| container_title | Journal of orthopaedic trauma |
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| creator | Das, Avishek Rollins, Katie E Elliott, Kathleen Johnston, Philip van-Rensburg, Lee Tytherleigh-Strong, Graham M Ollivere, Benjamin J |
| description | OBJECTIVES:Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before union.
DESIGN:Prospective comparative case series.
SETTING:Level 1 regional trauma center.
PATIENTS:Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.
INTERVENTION:Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3–12 weeks) fixation of displaced clavicle fractures.
OUTCOMES:Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.
RESULTS:There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.
CONCLUSION:Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.
LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. |
| doi_str_mv | 10.1097/BOT.0b013e3182a2968e |
| format | Article |
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DESIGN:Prospective comparative case series.
SETTING:Level 1 regional trauma center.
PATIENTS:Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.
INTERVENTION:Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3–12 weeks) fixation of displaced clavicle fractures.
OUTCOMES:Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.
RESULTS:There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.
CONCLUSION:Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.
LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.</description><identifier>ISSN: 0890-5339</identifier><identifier>EISSN: 1531-2291</identifier><identifier>DOI: 10.1097/BOT.0b013e3182a2968e</identifier><identifier>PMID: 23860135</identifier><language>eng</language><publisher>United States: by Lippincott Williams & Wilkins</publisher><subject>Adult ; Bone Plates ; Clavicle - diagnostic imaging ; Clavicle - injuries ; Clavicle - surgery ; Female ; Fracture Fixation, Internal ; Fractures, Bone - diagnostic imaging ; Fractures, Bone - surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Radiography ; Time Factors ; Young Adult</subject><ispartof>Journal of orthopaedic trauma, 2014-03, Vol.28 (3), p.119-123</ispartof><rights>2014 by Lippincott Williams & Wilkins</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356e-981ad7a80161010d9a3df98a39acc8ae4fdea95abac7460b528f3d65abd659393</citedby><cites>FETCH-LOGICAL-c356e-981ad7a80161010d9a3df98a39acc8ae4fdea95abac7460b528f3d65abd659393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23860135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Das, Avishek</creatorcontrib><creatorcontrib>Rollins, Katie E</creatorcontrib><creatorcontrib>Elliott, Kathleen</creatorcontrib><creatorcontrib>Johnston, Philip</creatorcontrib><creatorcontrib>van-Rensburg, Lee</creatorcontrib><creatorcontrib>Tytherleigh-Strong, Graham M</creatorcontrib><creatorcontrib>Ollivere, Benjamin J</creatorcontrib><title>Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures</title><title>Journal of orthopaedic trauma</title><addtitle>J Orthop Trauma</addtitle><description>OBJECTIVES:Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before union.
DESIGN:Prospective comparative case series.
SETTING:Level 1 regional trauma center.
PATIENTS:Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.
INTERVENTION:Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3–12 weeks) fixation of displaced clavicle fractures.
OUTCOMES:Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.
RESULTS:There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.
CONCLUSION:Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.
LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.</description><subject>Adult</subject><subject>Bone Plates</subject><subject>Clavicle - diagnostic imaging</subject><subject>Clavicle - injuries</subject><subject>Clavicle - surgery</subject><subject>Female</subject><subject>Fracture Fixation, Internal</subject><subject>Fractures, Bone - diagnostic imaging</subject><subject>Fractures, Bone - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0890-5339</issn><issn>1531-2291</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EoqXwBwhlySbFjyaxl9AHICp1U9haE2eiBtyk2Emr_j1GLSxYsJmRRufekQ4h14wOGVXZ3cNiOaQ5ZQIFkxy4SiWekD5LBIs5V-yU9KlUNE6EUD1y4f07pVRSzs9JjwuZhmTSJy9TcHYfvaHznY8maGGPRbTYoIO22mL0XLfotli3VVNHVR1NKr-xYAIztrCtjMVo5sC0nUN_Sc5KsB6vjntAXmfT5fgpni8en8f389iIJMVYSQZFBpKylFFGCwWiKJUEocAYCTgqCwSVQA4mG6U0T7gsRZGGQxhKKDEgt4fejWs-O_StXlfeoLVQY9N5zRLKpEjTTAR0dECNa7x3WOqNq9bg9ppR_a1RB436r8YQuzl-6PI1Fr-hH28BkAdg19ggyH_YbodOrxBsu_q_-wtRYYF5</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>Das, Avishek</creator><creator>Rollins, Katie E</creator><creator>Elliott, Kathleen</creator><creator>Johnston, Philip</creator><creator>van-Rensburg, Lee</creator><creator>Tytherleigh-Strong, Graham M</creator><creator>Ollivere, Benjamin J</creator><general>by Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201403</creationdate><title>Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures</title><author>Das, Avishek ; Rollins, Katie E ; Elliott, Kathleen ; Johnston, Philip ; van-Rensburg, Lee ; Tytherleigh-Strong, Graham M ; Ollivere, Benjamin J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356e-981ad7a80161010d9a3df98a39acc8ae4fdea95abac7460b528f3d65abd659393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Bone Plates</topic><topic>Clavicle - diagnostic imaging</topic><topic>Clavicle - injuries</topic><topic>Clavicle - surgery</topic><topic>Female</topic><topic>Fracture Fixation, Internal</topic><topic>Fractures, Bone - diagnostic imaging</topic><topic>Fractures, Bone - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Das, Avishek</creatorcontrib><creatorcontrib>Rollins, Katie E</creatorcontrib><creatorcontrib>Elliott, Kathleen</creatorcontrib><creatorcontrib>Johnston, Philip</creatorcontrib><creatorcontrib>van-Rensburg, Lee</creatorcontrib><creatorcontrib>Tytherleigh-Strong, Graham M</creatorcontrib><creatorcontrib>Ollivere, Benjamin J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Das, Avishek</au><au>Rollins, Katie E</au><au>Elliott, Kathleen</au><au>Johnston, Philip</au><au>van-Rensburg, Lee</au><au>Tytherleigh-Strong, Graham M</au><au>Ollivere, Benjamin J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures</atitle><jtitle>Journal of orthopaedic trauma</jtitle><addtitle>J Orthop Trauma</addtitle><date>2014-03</date><risdate>2014</risdate><volume>28</volume><issue>3</issue><spage>119</spage><epage>123</epage><pages>119-123</pages><issn>0890-5339</issn><eissn>1531-2291</eissn><abstract>OBJECTIVES:Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before union.
DESIGN:Prospective comparative case series.
SETTING:Level 1 regional trauma center.
PATIENTS:Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.
INTERVENTION:Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3–12 weeks) fixation of displaced clavicle fractures.
OUTCOMES:Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.
RESULTS:There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.
CONCLUSION:Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.
LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.</abstract><cop>United States</cop><pub>by Lippincott Williams & Wilkins</pub><pmid>23860135</pmid><doi>10.1097/BOT.0b013e3182a2968e</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Bone Plates Clavicle - diagnostic imaging Clavicle - injuries Clavicle - surgery Female Fracture Fixation, Internal Fractures, Bone - diagnostic imaging Fractures, Bone - surgery Humans Male Middle Aged Prospective Studies Radiography Time Factors Young Adult |
| title | Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures |
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