This article is more than 5 years old. Information may no longer be current.
Operative, nonoperative treatment of pediatric clavicle factures offer similar outcomes
Researchers found no significant differences in outcome measures between pediatric patients treated operatively and nonoperatively for clavicle fractures, according to recently published data.
The researchers retrospectively reviewed the charts of pediatric patients treated for clavicle fractures between January 2001 and October 2011. Thirty-two patients were treated nonoperatively, and 46 patients underwent open reduction and internal fixation (ORIF) of a displaced clavicle fracture.
Patients included in the operative group had an absolute indication for operative fixation, more than 100% displacement of fracture fragments, 1.5 cm or greater shortening and any fracture through a previously nondisplaced clavicle fracture. Mean age of patients in the nonoperative group was 10.3 years, and patients in the operative group had a mean age of 13.6 years.
All patients in the study were contacted and asked to complete a Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to determine long-term clinical function. Mean follow-up was 54 months in the nonoperative group and 41 months in the operative group.
Results showed the nonoperative group’s mean time to return to activity was 12.24 weeks, compared with 12.7 weeks in the operative group. Additionally, patients’ mean time to full active range of motion in the nonoperative group was 7.85 weeks vs. 8.74 weeks in the operative group. Full radiographic healing occurred at a mean of 12.02 weeks for the nonoperative group and 11.9 weeks for the operative group, according to the researchers.
There were no significant differences observed between the nonoperative and operative group’s DASH scores (0.04 vs. 1.17).
The researchers concluded that orthopedic surgeons who treat pediatric patients with clavicle fractures and other injuries should manage the injury nonoperatively unless there is an absolute indication for surgery, as nonoperative management provides similar immediate and long-term clinical results. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.