Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures
Background: Clavicle fractures are relatively common, and most often occur in the middle third. Fractures that are not displaced or are displaced with no other indication for surgical intervention are treated supportively. Displaced fractures that have been managed non-surgically have had acceptabl...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Tehran University of Medical Sciences
2025-06-01
|
| Series: | Journal of Orthopedic and Spine Trauma |
| Subjects: | |
| Online Access: | https://jost.tums.ac.ir/index.php/jost/article/view/630 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850116180611694592 |
|---|---|
| author | Mahdi Rezai Ashkan Khodamoradi Aidin Mohammad Valipour Roxana Hessam Mehdi Mohammadi Kourosh Javdani Esfahani Ahmadreza Kheradpishe |
| author_facet | Mahdi Rezai Ashkan Khodamoradi Aidin Mohammad Valipour Roxana Hessam Mehdi Mohammadi Kourosh Javdani Esfahani Ahmadreza Kheradpishe |
| author_sort | Mahdi Rezai |
| collection | DOAJ |
| description |
Background: Clavicle fractures are relatively common, and most often occur in the middle third. Fractures that are not displaced or are displaced with no other indication for surgical intervention are treated supportively. Displaced fractures that have been managed non-surgically have had acceptable outcomes. The goal of this study is to evaluate pain scores, the resumption of daily activities, rates of acceptable healing, non-union, malunion, and the need for additional surgical intervention. Methods: This observational study was conducted on 432 patients with midclavicular fractures who were referred to a high-level trauma center. All patients were treated non-surgically and followed for six months. The primary outcomes were patients’ function or disability, assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) and University of California, Los Angeles (UCLA) scores. The secondary outcomes included the rate of pain relief, measured by the Verbal Numeric Scale (VNS) score, as well as complications such as malunion, nonunion, and the need for secondary surgical intervention. Results: A total of 432 patients were enrolled. The rates of malunion and nonunion were 63.4% and 2.3%, respectively. Patients with malunion exhibited a higher pain score (P < 0.001). The average UCLA score among patients was 32.53, which corresponds to good and excellent grades; it was significantly lower for those with malunion (P < 0.001). The mean DASH score was 5.92, and there was no significant difference between the two groups regarding malunion and normal union (P > 0.05). Conclusion: Our study demonstrated a low non-union rate, good functionality, and a high rate of satisfaction among patients with middle third clavicle fractures who were treated non-surgically.
|
| format | Article |
| id | doaj-art-8da7ac6ce859470588dfef94fd69612d |
| institution | OA Journals |
| issn | 2538-2330 2538-4600 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Orthopedic and Spine Trauma |
| spelling | doaj-art-8da7ac6ce859470588dfef94fd69612d2025-08-20T02:36:23ZengTehran University of Medical SciencesJournal of Orthopedic and Spine Trauma2538-23302538-46002025-06-0111210.18502/jost.v11i2.18883Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third FracturesMahdi Rezai0Ashkan Khodamoradi1Aidin Mohammad Valipour2Roxana Hessam3Mehdi Mohammadi4Kourosh Javdani Esfahani5Ahmadreza Kheradpishe6Emergency Medicine Management Research Center, Health Management Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IranDepartment of Emergency Medicine, School of Medicine, Iran University of Medical SciencesDepartment of Emergency Medicine, School of Medicine, Iran University of Medical SciencesDepartment of Emergency Medicine, School of Medicine, Iran University of Medical SciencesDepartment of Emergency Medicine, Iran University of Medical Sciences, Tehran, IranIranian Hospital, Dubai, UAEStudent Research Committee, Iran University of Medical Sciences, Tehran, Iran Background: Clavicle fractures are relatively common, and most often occur in the middle third. Fractures that are not displaced or are displaced with no other indication for surgical intervention are treated supportively. Displaced fractures that have been managed non-surgically have had acceptable outcomes. The goal of this study is to evaluate pain scores, the resumption of daily activities, rates of acceptable healing, non-union, malunion, and the need for additional surgical intervention. Methods: This observational study was conducted on 432 patients with midclavicular fractures who were referred to a high-level trauma center. All patients were treated non-surgically and followed for six months. The primary outcomes were patients’ function or disability, assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) and University of California, Los Angeles (UCLA) scores. The secondary outcomes included the rate of pain relief, measured by the Verbal Numeric Scale (VNS) score, as well as complications such as malunion, nonunion, and the need for secondary surgical intervention. Results: A total of 432 patients were enrolled. The rates of malunion and nonunion were 63.4% and 2.3%, respectively. Patients with malunion exhibited a higher pain score (P < 0.001). The average UCLA score among patients was 32.53, which corresponds to good and excellent grades; it was significantly lower for those with malunion (P < 0.001). The mean DASH score was 5.92, and there was no significant difference between the two groups regarding malunion and normal union (P > 0.05). Conclusion: Our study demonstrated a low non-union rate, good functionality, and a high rate of satisfaction among patients with middle third clavicle fractures who were treated non-surgically. https://jost.tums.ac.ir/index.php/jost/article/view/630ClavicleFractureConservative TreatmentUnion |
| spellingShingle | Mahdi Rezai Ashkan Khodamoradi Aidin Mohammad Valipour Roxana Hessam Mehdi Mohammadi Kourosh Javdani Esfahani Ahmadreza Kheradpishe Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures Journal of Orthopedic and Spine Trauma Clavicle Fracture Conservative Treatment Union |
| title | Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures |
| title_full | Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures |
| title_fullStr | Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures |
| title_full_unstemmed | Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures |
| title_short | Long-Term Functional Outcomes and Complications of Non-Surgical Management for Clavicular Middle Third Fractures |
| title_sort | long term functional outcomes and complications of non surgical management for clavicular middle third fractures |
| topic | Clavicle Fracture Conservative Treatment Union |
| url | https://jost.tums.ac.ir/index.php/jost/article/view/630 |
| work_keys_str_mv | AT mahdirezai longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT ashkankhodamoradi longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT aidinmohammadvalipour longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT roxanahessam longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT mehdimohammadi longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT kouroshjavdaniesfahani longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures AT ahmadrezakheradpishe longtermfunctionaloutcomesandcomplicationsofnonsurgicalmanagementforclavicularmiddlethirdfractures |