Comparison of results between conservative treatment and operative treatment for clavicle fractures in adults

Baek, Dae Hyun; Sohn, Jong Min; Jahng, Juhae; Kim, Hyoung Kwan; Ha, Nan Kyung; Lim, Kwahn Sue

Abstract

PURPOSE
The conservative treatment in the clavicular fractures is the gold standard. However, we found that there were some complications including angulation of clavicle and shortening of clavicular length, long-period immobilization, and nonunion in conservative treatment. This study was undertaken to evaluate union period, nonunion rate, and clinical results between conservative treatment and surgical treatment in clavicular fractures.
MATERIALS AND METHODS
We evaluated 67 clavicular fractures in adults with conservative treatment (42 cases) and operative treatment (25 cases) from 1991 to 1996 and followed up for at least 1 year.
RESULTS
Nonunion occurred in 4 cases (9.5%) in conservative treatment and 1 case (4.0%) in operative treatment (p>0.05) . The excellent results were 12 cases (28.6%) in conservative treatment and 12 cases (48.0%) in operative treatment (p>0.05) .
CONCLUSION
We concluded that the early surgical treatment of displaced, low contact area of fracture segments of the clavicle fracture with internal fixation, even though not statistically significant, provides clinical results that are superior to those obtained with conservative care in view of early exercise of the shoulder joint, union period, rate of nonunion, correction of angular deformity and cosmetic problem. We thought that it leaves much room for consideration about the early surgical treatment for these fractures.