A Jubel1, G Schiffer2, J Andermahr3, C Ries4, C Faymonville4. 1. Klinik für Unfall- und Wiederherstellungschirurgie, Eduardus-Krankenhaus, Custodisstr. 3-17, 50679, Köln, Deutschland. axeljubel@t-online.de. 2. Abteilung Unfallchirurgie, Handchirurgie und Orthopädie, Vinzenz Pallotti Hospital, Bergisch Gladbach, Deutschland. 3. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kreiskrankenhaus Mechernich GmbH, Mechernich, Deutschland. 4. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinikum Köln, Köln, Deutschland.
Abstract
OBJECTIVE: The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities. MATERIAL AND METHODS: The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles. RESULTS: Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001). CONCLUSION: The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.
OBJECTIVE: The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities. MATERIAL AND METHODS: The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles. RESULTS:Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001). CONCLUSION: The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.
Authors: Michael D McKee; Elizabeth M Pedersen; Caroline Jones; David J G Stephen; Hans J Kreder; Emil H Schemitsch; Lisa M Wild; Jeffrey Potter Journal: J Bone Joint Surg Am Date: 2006-01 Impact factor: 5.284
Authors: Cara H Lai; Malcolm R DeBaun; Noelle Van Rysselberghe; Geoffrey D Abrams; Robin N Kamal; Julius A Bishop; Michael J Gardner Journal: J Orthop Trauma Date: 2021-03-01 Impact factor: 2.884