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Clin Shoulder Elbow > Volume 12(1); 2009 > Article
Journal of the Korean Shoulder and Elbow Society 2009;12(1):61-66.
DOI: https://doi.org/10.5397/CiSE.2009.12.1.061    Published online June 30, 2009.
Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle
Doo Sub Kim, Jung Ho Rah, Yeo Seung Yoon, Chang Ho Lee
Department of Orthopedic Surgery, Wonju College of Medicine Yonsei university, Korea. dskim1974@hanmail.net
쇄골 전위성 간부 골절에서 조기 고정술 군과 지연 재건술 군 간의 결과 비교
연세대학교 원주의과대학 정형외과학교실
Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. MATERIALS AND METHODS: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union.
The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group.
Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options
Key Words: Clavicle; Displaced mid-shaft fracture; Immediate fixation group; Delayed reconstruction group


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