Clinical Orthopaedics and Related Research®

, Volume 469, Issue 12, pp 3351–3355

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

  • Laura A. Schemitsch
  • Emil H. Schemitsch
  • Christian Veillette
  • Rad Zdero
  • Michael D. McKee
Symposium: Fractures of the Shoulder Girdle

DOI: 10.1007/s11999-011-1915-x

Cite this article as:
Schemitsch, L.A., Schemitsch, E.H., Veillette, C. et al. Clin Orthop Relat Res (2011) 469: 3351. doi:10.1007/s11999-011-1915-x

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.

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Laura A. Schemitsch
    • 1
  • Emil H. Schemitsch
    • 1
  • Christian Veillette
    • 1
  • Rad Zdero
    • 1
  • Michael D. McKee
    • 1
  1. 1.Upper Extremity Reconstructive ServiceSt Michael’s Hospital and the University of TorontoTorontoCanada

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