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Plate fixation of clavicular fractures yielded higher satisfaction vs nonoperative treatment
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Patients with midshaft clavicular fractures treated with plate fixation experienced higher patient satisfaction with the cosmetic result and less subjective limitations in daily life compared with patients who had nonoperative treatment, according to results.
Researchers randomly assigned 160 patients with a midshaft clavicular fracture that was at least one shaft-width displaced to undergo either open reduction and plate fixation or nonoperative treatment. Researchers evaluated overall satisfaction with the treatment, satisfaction with the cosmetic result and satisfaction with the function of the shoulder. Researchers also recorded residual symptoms and any reoperations, and measured perceived impact of symptoms, limitations in daily life activities and if patients would undergo the same treatment again.
Overall, 49% of patients responded after a median follow-up of 53 months since the start of the initial treatment. Results showed patients in the plate fixation group and nonoperative group had similar scores for overall satisfaction with the received treatment and satisfaction with the function of the shoulder. However, researchers found higher satisfaction with cosmetic results among patients in the plate fixation group.
According to results, less than half of the patients in both groups felt that their shoulder had fully recovered. Researchers found residual symptoms were common, with 35% and 32% of patients experiencing residual symptoms mostly every day or week, respectively. Although more patients reported limitations of daily life activities after nonoperative treatment, results showed the perceived impact of symptoms did not differ between the groups. Researchers found 88% of patients in the plate fixation group would prefer the same treatment if they were to fracture their contralateral clavicle in the future vs. 41% of patients in the nonoperative group.
“When discussing treatment options for clavicular fractures, the patient should be informed objectively about options and potential sequelae to select the treatment that suits the individual patient best and to adequately manage the patient’s expectations,” the authors wrote. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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