The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle

Cha,  Seung Do; Chung,  Soo Tai; Kim,  Yong Hoon; Park,  Sang Jun

doi:2010.13.1.27

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Original Article

Journal of the Korean Shoulder and Elbow Society 2010;13(1):27-33.
DOI: https://doi.org/10.5397/CiSE.2010.13.1.027 Published online June 30, 2010.

The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle

Seung Do Cha, Soo Tai Chung, Yong Hoon Kim, Sang Jun Park

Department of Orthopaedic Surgery, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea. seust@chol.com

쇄골 간부 골절의 보존적 치료 분석

차승도·정수태·김용훈·박상준

관동대학교 의과대학 명지병원 정형외과학교실

Abstract

PURPOSE
Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. MATERIALS AND METHODS: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment.
RESULTS
The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment.
CONCLUSION
In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.

Key Words: Clavicle fracture; Conservative treatment; Bone union

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