期刊论文详细信息
BMC Musculoskeletal Disorders
Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function
Fábio Teruo Matsunaga1  Marcelo Hide Matsumoto1  Nicola Archetti Netto1  Artur Yudi Utino1  Bruno Dragone1  Marcel Jun Sugawara Tamaoki1  Gustavo Santiago de Lima Figueiredo1 
[1] Orthopaedics and Traumatology Department, São Paulo Federal University, Napoleão de Barros Street 715, São Paulo, Brasil
关键词: DASH;    Conservative treatment;    Shortening;    Clavicle;    Fracture;   
Others  :  1227744
DOI  :  10.1186/s12891-015-0585-3
 received in 2015-03-12, accepted in 2015-05-18,  发布年份 2015
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【 摘 要 】

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Trial registration

ISRCTN85206617. Registered 12 May 2014

【 授权许可】

   
2015 Figueiredo et al.

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【 参考文献 】
  • [1]Robinson CM. Fractures of the clavicle in the adult. J Bone Joint Surg (Br). 1998; 80B:476-84.
  • [2]Craig EV. Fractures of the clavicle. In: The shoulder. Rockwood CA, Matsen FA, editors. WB Saunders, Philadelphia; 1990: p.367-412.
  • [3]Craig EV. Fractures of the clavicle. In: Rockwood and green's fractures in adults. Rockwood CA, Green DP, Bucholz RW, Heckman JD, editors. Lippincott-Raven, Philadelphia; 1996: p.1109-61.
  • [4]Craig EV. Fractures of the clavicle. In: The shoulder. 3rd ed. Rockwood CA, Matsen FA, editors. WB Saunders, Philadelphia; 1998: p.428-82.
  • [5]Crenshaw AH. Fractures of the shoulder girdle, arm and forearm. In: Campbell's operative orthopaedics. 8th ed. Willis CC, editor. Mosby-Year Book, St. Louis; 1992: p.989-95.
  • [6]Robinson CM, Cairns DA. Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surge Am. 2004; 86A:778-82.
  • [7]Ledger M, Leeks N, Ackland T, Wang A. Short malunions of the clavicle: an anatomic and functional study. J Shoulder Elbow Surg. 2005; 14:349-54.
  • [8]Neer CS. Nonunion of the clavicle. JAMA. 1960; 172:1006-11.
  • [9]Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop. 1968; 58:29-42.
  • [10]Rasmussen JV, Jensen SL, Petersen JB, Falstie-Jensen T, Lausten G, Olsen BS. A retrospective study of the association between shortening of the clavicle after fracture and the clinical outcome in 136 patients. Injury, Int J Care Injured. 2011; 42:414-7.
  • [11]Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg (Br). 1997; 79B:537-9.
  • [12]Zlowodzki M, Zelle BA, Cole PA et al.. Treatment of midshaft clavicle fractures: systemic review of 2144 fractures. J Orthop Trauma. 2005; 19:504-7.
  • [13]Andermahr J, Jubel A, Elsner A et al.. Malunion of the clavicle causes significant glenoid malposition: a quantitative anatomic investigation. Surg Radiol Anat. 2006; 28:447-56.
  • [14]Postacchini R, Gumina S, Farsetti P, Postacchini F. Long-term results of conservative management of midshaft clavicle fracture. Int Orthop. 2010; 34(5):731-6.
  • [15]Faldini C, Nanni M, Leonetti D, Acri F, Galante C, Luciani D, Giannini S. Nonoperative treatment of closed displaced midshaft clavicle fractures. J Orthop Traumatol. 2010; 11(4):229-36.
  • [16]Kay SP, Dragoo JL, Lee R. Long-term results of arthroscopic resection of the distal claviclewith concomitant subacromial decompression. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2003; 19(8):805-9.
  • [17]McKee RC, Whelan DB, Schemitsch EH, McKee MD. Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials. J Bone Joint Surg Am. 2012; 94:675-84.
  • [18]Eskola A, Vainionpaa S, Myllynen P et al.. Outcome of clavicular fracture in 89 patients. Arch Orthop Trauma Surg. 1986; 105:337-8.
  • [19]Nordqvist A, Redlund-Johnell I, Von Scheele A, Petersson CJ. Shortening of clavicle after fracture. Incidence and clin- ical significance, a 5-year follow-up of 85 patients. Acta Orthop Scan. 1997; 68:349-51.
  • [20]De Giorgi S, Notarnicola A, Tafuri S, Solarino G, Moretti LMB. Conservative treatment of fractures of the clavicle. BMC Research Notes. 2011; 4:333. BioMed Central Full Text
  • [21]Nowak J, Holgersson M, Larsson S. Sequelae from clavicular fractures are common: a prospective study of 222 patients. Acta Orthop. 2005; 76(4):496-502.
  • [22]Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J Shoulder Elbow Surg. 2006; 15(2):191-4.
  • [23]Inman VT, Saunders JB. Observations on the function of the clavicle. Calif Med. 1946; 65(4):158-66.
  • [24]Orfale AG, Araújo PMP, Ferraz MB, Natour J. Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the disabilities oh the arm, shoulder and hand questionnaire. Braz J Med Biol Res. 2005; 38:293-302.
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