A comparison of nonoperative and operative treatment of type II distal clavicle fractures.

A retrospective study was performed to compare nonoperative and operative treatments of Type II distal clavicle fractures. From a total of 30 diagnosed patients, 16 were identified as receiving nonoperative treatment and 14 open reduction and coracoclavicular stabilization. The average follow-up was 53.5 months for the nonoperative group and 59.8 months for the operative group. All patients were evaluated postoperatively for pain, range of motion, function, and fracture healing as well as for isokinetic strength. Fractures treated surgically achieved union within six to ten weeks. Nonoperative treatment resulted in seven nonunions. There were no significant differences between the two groups in the mean UCLA, Constant, and ASES scores. Nonunion had no significant effect on functional outcome or strength. This study suggests that Type II distal clavicle fractures can be successfully managed nonoperatively. The high incidence of nonunion does not impede a clinical outcome comparable to that achieved by surgical treatment.

[1]  P. Myllynen,et al.  Outcome of clavicular fracture in 89 patients , 2004, Archives of orthopaedic and traumatic surgery.

[2]  J. Jupiter,et al.  Clavicular Nonunion and Malunion: Evaluation and Surgical Management , 1996, The Journal of the American Academy of Orthopaedic Surgeons.

[3]  L. Gotzen,et al.  Treatment of unstable distal clavicular fractures with and without lesions of the acromioclavicular joint. , 1996, Injury.

[4]  V C Mow,et al.  A standardized method for the assessment of shoulder function. , 1994, Journal of shoulder and elbow surgery.

[5]  I. Redlund‐Johnell,et al.  The natural course of lateral clavicle fracture. 15 (11-21) year follow-up of 110 cases. , 1993, Acta orthopaedica Scandinavica.

[6]  D. J. Edwards,et al.  Fractures of the distal clavicle: a case for fixation. , 1992, Injury.

[7]  C. Gerber,et al.  Coracoclavicular screw fixation for unstable fractures of the distal clavicle. A report of five cases. , 1991, The Journal of bone and joint surgery. British volume.

[8]  M. Bosse,et al.  Type II Distal Clavicle Fractures: A Retrospective Review of Surgical Treatment , 1990, Journal of orthopaedic trauma.

[9]  M. Post.  Current concepts in the treatment of fractures of the clavicle. , 1989, Clinical orthopaedics and related research.

[10]  D. Stanley,et al.  Recovery following fractures of the clavicle treated conservatively. , 1988, Injury.

[11]  C. Constant,et al.  A clinical method of functional assessment of the shoulder. , 1987, Clinical orthopaedics and related research.

[12]  S. Vainionpää,et al.  Outcome of operative treatment in fresh lateral clavicular fracture. , 1987, Annales chirurgiae et gynaecologiae.

[13]  G. Hanker,et al.  Repair of the rotator cuff. End-result study of factors influencing reconstruction. , 1986, The Journal of bone and joint surgery. American volume.

[14]  M. Rosen,et al.  Open reduction and internal fixation of clavicular fractures. , 1981, The Journal of bone and joint surgery. American volume.

[15]  Heppenstall Rb.  Fractures and dislocations of the distal clavicle. , 1975 .

[16]  P. V. Zav'iavlov,et al.  [Fractures of the clavicle]. , 1975, Khirurgiia.

[17]  M. Mital,et al.  Advances in the management of fractures and dislocations in the past decade. , 1972, The Orthopedic clinics of North America.

[18]  C. Rowe.  An atlas of anatomy and treatment of midclavicular fractures. , 1968, Clinical orthopaedics and related research.

[19]  C. Neer.  Fractures of the distal third of the clavicle. , 1968, Clinical orthopaedics and related research.

[20]  F. Allman.  Fractures and ligamentous injuries of the clavicle and its articulation. , 1967, The Journal of bone and joint surgery. American volume.

[21]  J. S. Neviaser.  THE TREATMENT OF FRACTURES OF THE CLAVICLE. , 1963, The Surgical clinics of North America.

[22]  E. V. Davis.  Nonunion of the clavicle; a case report. , 1949, The Journal of the Medical Society of New Jersey.