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Acute medial clavicle fracture in adults: a systematic review of demographics, clinical features and treatment outcomes in 220 patients

BACKGROUND: Medial third clavicle fractures are rare injuries, with limited information available on their characteristics or treatment results. MATERIALS AND METHODS: We performed a systematic review according to PRISMA guidelines to evaluate the demographics, clinical profile, management and treat...

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Detalles Bibliográficos
Autores principales: Asadollahi, Saeed, Bucknill, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598891/
https://www.ncbi.nlm.nih.gov/pubmed/31254115
http://dx.doi.org/10.1186/s10195-019-0533-3
Descripción
Sumario:BACKGROUND: Medial third clavicle fractures are rare injuries, with limited information available on their characteristics or treatment results. MATERIALS AND METHODS: We performed a systematic review according to PRISMA guidelines to evaluate the demographics, clinical profile, management and treatment outcome. Electronic searches of the MEDLINE, EMBASE and Cochrane databases were performed. RESULTS: Seventeen studies were included, consisting of 7 case series and 10 case reports. Two hundred twenty fractures were identified. Seventy-eight percent of fractures occurred in men with mean age of 48 years (16–94 years). Road traffic accident was the most common mechanism of injury (64%). Associated injuries occurred in 81% of patients, with thoracic trauma being the most common (47%). The most common fracture type was extra-articular, with no or minimal displacement (60%). In 9% of patients the fracture was segmental. One hundred ninety-one patients received nonoperative treatment. Twenty-nine patients were treated operatively. The overall nonunion rate was 5% (7/137). The nonunion rate following nonoperative management was 4.6% (5/108). The functional result following nonoperative treatment indicated overall “good” functional outcome. There was no report of catastrophic intraoperative complication amongst patients undergoing surgical fixation. CONCLUSION: Medial third clavicle fractures represent a distinct subgroup of clavicle fractures. Nonoperative treatment of these fracture seems to result in high union rate and overall favourable functional outcome. Further high-quality research in this area is warranted to investigate the outcomes and indication for nonoperative versus operative management of these fractures. LEVEL OF EVIDENCE: IV.