LONG-TERM RESULTS OF NON-SURGICAL MANAGEMENT FOR CLAVICULAR MIDDLE THIRD FRACTURES

Background and Aim : Clavicle fractures are relatively common and most of them occur in itsmiddle third. Fractures that are not displaced or displaced with no other indication for surgicalintervention, are treated supportively; displaced fractures which have been managed nonsurgically,have had acceptable outcomes. We designed a study to follow the long-term (6 month)outcome of these cases which have been managed non-surgically by emergency physicians.Methods : This was an observational study carried on 216 patients with midclavicular fracturesreferred to a high level trauma center. All of patients were treated non-surgically and followed upfor 6 months. The primary outcomes were patients’ function or disability, based on DASH(Disabilities of the Arm Shoulder and Hand) and UCLA (University of California at Los Angeles)scores. The secondary outcomes were the rate of pain relief, based on Verbal Numeric Scale (VNS)score and complications including mal-union, non-union, and need of secondary surgicalintervention.Results : 216 patients were enrolled. The rate of mal-union and non-union were 63.4% and 2.3%,respectively. The pain score was higher in patients with mal-union (p< 0.001). The average UCLAscore of patients was 32.53, which equals to and good and excellent grades; it was significant lylower in those with mal-union (p<0.001). The mean DASH score was 5.92, and there was nosignificant difference between the two groups with mal-union and normal union (p-value > 0.05).Conclusion : Our study showed low non-union rate, good function, and high satisfaction rate inpatients with fractures of middle third of clavicle who were managed non-surgically.

Keywords:

Clavicle , Fracture , Union , Conservative Treatment