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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2011

01-12-2011 | Symposium: Fractures of the Shoulder Girdle

Function Plateaus by One Year in Patients With Surgically Treated Displaced Midshaft Clavicle Fractures

Authors: Laura A. Schemitsch, Emil H. Schemitsch, MD, FRCS(C), Christian Veillette, MD, MSc, FRCS(C), Rad Zdero, PhD, Michael D. McKee, MD, FRCS(C)

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2011

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Abstract

Background

Based on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear.

Questions/purposes

For displaced midshaft clavicle fractures, do the better mean Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley Shoulder (CSS) scores for operative versus nonoperative treatment at 1 year change between 1- and 2-year followup?

Patients and Methods

We previously reported 132 patients in a randomized prospective trial at 1 year, and here we report a further followup of 95 of the 132 patients (72%) at 2 years after injury. We evaluated all patients with the DASH and CSS scores.

Results

The mean DASH and CSS scores were similar at 2 years compared with 1 year postinjury for both the nonoperated and operated patients. The mean scores for the operated patients remained higher than those in the nonoperative group (DASH operative 4.1 ± 7.0 versus DASH nonoperative 11.4 ± 19.7, CSS operative 97.1 ± 4.5 versus CSS nonoperative 91.6 ± 14.1) at 2 years postinjury.

Conclusions

The improvement in DASH and CSS scores seen with primary fixation of displaced clavicle fractures persists at 2 years but does not differ from values seen after 1 year of followup, suggesting a clinical steady state has been reached whereby outcome is unlikely to change with time.

Level of Evidence

Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Function Plateaus by One Year in Patients With Surgically Treated Displaced Midshaft Clavicle Fractures
Authors
Laura A. Schemitsch
Emil H. Schemitsch, MD, FRCS(C)
Christian Veillette, MD, MSc, FRCS(C)
Rad Zdero, PhD
Michael D. McKee, MD, FRCS(C)
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-1915-x

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