• Laura A Schemitsch, Emil H Schemitsch, Christian Veillette, Rad Zdero, and Michael D McKee.
• Upper Extremity Reconstructive Service, St Michael's Hospital, University of Toronto, Suite 800, 55 Queen Street E, Toronto, Ontario M5C 1R6, Canada.
• Clin. Orthop. Relat. Res. 2011 Dec 1;469(12):3351-5.

BackgroundBased on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear.Questions/PurposesFor displaced midshaft clavicle fractures, do the better mean Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley Shoulder (CSS) scores for operative versus nonoperative treatment at 1 year change between 1- and 2-year followup?Patients And MethodsWe previously reported 132 patients in a randomized prospective trial at 1 year, and here we report a further followup of 95 of the 132 patients (72%) at 2 years after injury. We evaluated all patients with the DASH and CSS scores.ResultsThe mean DASH and CSS scores were similar at 2 years compared with 1 year postinjury for both the nonoperated and operated patients. The mean scores for the operated patients remained higher than those in the nonoperative group (DASH operative 4.1 ± 7.0 versus DASH nonoperative 11.4 ± 19.7, CSS operative 97.1 ± 4.5 versus CSS nonoperative 91.6 ± 14.1) at 2 years postinjury.ConclusionsThe improvement in DASH and CSS scores seen with primary fixation of displaced clavicle fractures persists at 2 years but does not differ from values seen after 1 year of followup, suggesting a clinical steady state has been reached whereby outcome is unlikely to change with time.Level Of EvidenceLevel I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

20 keywords...

hide…