OBJECTIVE: To compare non-surgical treatment and surgical treatment using an anterior plate through a functional evaluation of patients with midshaft clavicle fractures after 12 months of follow-up. METHODS: A prospective study was performed from August 2005 to January 2007, when 50 patients with midshaft clavicle fracture with displacement were randomly divided into two groups. 10 of the patients were excluded from the series because they were lost in follow-up. Group 1 was submitted to surgical treatment with reduction and fixation of the clavicle with an anterior plate. Group 2 was treated using a sling. After the minimum follow-up period of 12 months, a comparative analysis was performed using the AAOS and the UCLA scales as parameters. RESULTS: Mean age was approximately 30 years (ranging from 18 to 58 years), and 77.5% of the patients were male. The right side was most often involved (55%) and it was the dominant shoulder in those patients. The trauma mechanisms found most often were traffic accidents (75% of the cases). According to UCLA criteria, group 1 had 91.5% of the patients with results considered satisfactory (good and excellent), whereas group 2 presented 81.25%. Return to work and to daily-life activities was faster in group 1, with a mean of 8.67 weeks, whereas group 2 took 15.13 weeks. As to complications, the authors mention, for group 1, hypertrophic scarring (12.5%), pseudoarthrosis (8.3%), residual pain (8.3%), loosening of the material (4.1%). In group 2, complications were: esthetic deformity (43.75%), adhesive capsulitis (12.5%), and pseudoarthrosis (6.25%). CONCLUSION: After 12 months of follow-up, surgical treatment provided faster return to daily-life activities, with higher percentage of functional results according to the UCLA scale, but this was not statistically significant, compared to the non-surgical treatment.
Clavicle; Clavicle; Fractures, bone; Fractures, bone; Prospective studies
