A Recent Study Evaluated the Effects of Open Reduction and Internal Fixation Versus Non-Surgical Therapy in Displaced Midshaft Clavicle Fractures

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A Recent Study Evaluated the Effects of Open Reduction and Internal Fixation Versus Non-Surgical Therapy in Displaced Midshaft Clavicle Fractures

A recent meta-analysis examined the open reduction and internal fixation (ORIF) and non-surgical therapy results in displaced midshaft clavicle fractures.

The randomised controlled trials reporting nonunion, shoulder functional results, and subsequent surgery rates or pain scores were included in the study. Data was extracted from PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched upto September 2017. The studies with patients younger than 16 years, maximum follow-up less than nine months, and inaccessible full-text were excluded.

The extracted data involved the first author, year of publication, number of patients,  Constant scores of disabilities of the arm, shoulder and hand (DASH) scores, number of nonunions, and number of subsequent surgeries, and pain marked using the visual analogue scale.

Various parameters such as the risk ratio (RR) of nonunion was 0.15 (95% confidence interval [CI], 0.08, 0.31) in ORIF compared with that of non-surgical therapy. Constant and DASH scores were significantly better in ORIF up to 6 months. The mean difference (MD) in DASH scores at 12 months was not significant statistically in both therapies (MD, -4.19; 95% CI, -9.34, 0.96). Constant scores remained notable in ORIF (MD, 4.39; 95% CI, 1.03, 7.75). Subsequent surgeries and pain scores were related to both operations.

Significant reduction in nonunions and favourable early functional results were correlated with ORIF. Nevertheless, late functional results, subsequent surgeries, and pain scores are similar to those of non-surgical therapy. As a conclusion, evidence regarding the best treatment for displaced midshaft clavicle fractures was found to be inconsistent.

Source:                       

J Orthop Trauma.

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/29672340 

The original title of the article:

Open Reduction and Internal Fixation versus Non-Surgical Treatment in Displaced Midshaft Clavicle Fractures: A Meta-Analysis

Authors

Ahmed; A. et al.

SearchTags: 
Therapeutic, Clavicle Fractures, Shoulder, Meta-Analysis, Randomized controlled, Visual analogue scale.
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