TY  - JOUR
T1  - Sling Compared with Plate Osteosynthesis for Treatment of Displaced Midshaft Clavicular FracturesA Randomized Clinical Trial
AU  - Virtanen, Kaisa J.
AU  - Remes, Ville
AU  - Pajarinen, Jarkko
AU  - Savolainen, Vesa
AU  - Björkenheim, Jan-Magnus
AU  - Paavola, Mika
Y1  - 2012/09/05
N1  - 10.2106/JBJS.J.01999
JO  - The Journal of Bone & Joint Surgery
SP  - 1546
EP  - 1553
VL  - 94
IS  - 17
N2  - Background: 
  Few randomized controlled trials have compared operative with nonoperative treatment of clavicular fractures.Methods: 
  Patients with displaced midshaft clavicular fractures were randomized either to nonoperative treatment with a sling or to operative treatment with a stainless steel 3.5-mm reconstruction plate. Outcome measures were the Constant shoulder score, DASH (Disabilities of the Arm, Shoulder and Hand) score, pain, fracture-healing, and complications. The null hypothesis was that the Constant and DASH scores would not differ between the groups at the one-year follow-up evaluation.Results: 
  In accordance with the power analysis, we included sixty patients in the study; thirty-two were randomized to the nonoperative group and twenty-eight to the operative group. We found no difference in the Constant score (p = 0.75), the DASH score (p = 0.89), or pain (p = 0.98) between the groups at the one-year follow-up evaluation. All fractures in the operative group healed, but six nonunions (24%) occurred in the nonoperative group.Conclusions: 
  One year after a displaced midshaft clavicular fracture, nonoperative treatment resulted in a higher nonunion rate but similar function and disability compared with operative treatment.Level of Evidence: 
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.J.01999
UR  - http://dx.doi.org/10.2106/JBJS.J.01999
ER  -