Nonoperative versus operative treatment for displaced midshaft clavicle fractures in adolescents: a comparative study.

We aimed to compare the outcomes and complications of nonoperative and operative treatment for displaced midshaft clavicle fractures in adolescents. Radiological and functional evaluations and complications for 23 patients with nonoperative treatment were compared with those for 18 patients with operative treatment. No nonunion developed in either group. No significant intergroup differences were observed for occurrence of delayed union or time to union (P=0.851 and 0.887, respectively). Both groups showed excellent functional outcomes on the basis of Disabilities of the Arm, Shoulder and Hand scores and Constant Shoulder Scores. Shoulder abduction strength and range of motion were also well restored in both treatment groups. However, recovery of shoulder range of motion was significantly faster in the operative group (mean: 5.3 weeks; range: 4.0-7.0 weeks) than in the nonoperative group (mean: 9.9 weeks; range: 8.0-19.0 weeks) (P<0.001). There were no patients in either treatment group who needed revisional surgery to address complications with functional deficits. Both nonoperative and operative treatments yielded excellent outcomes, without severe complications. On the basis of our results, nonoperative treatment is recommended as a primary treatment option for displaced midshaft clavicle fractures in adolescents. However, operative treatment can be considered in selected patients who require early functional recovery or have a high activity level.

Arthroscopic treatment of greater tuberosity fractures : retrospective review of clinical and radiological outcomes.

The purpose of this retrospective study was to analyze the clinical and radiological outcomes and discuss the value of arthroscopic suture bridge technique in patients with isolated greater tuberosity fractures. Between October 2009 and July 2014, 37 patients with greater tuberosity fractures were analyzed. Thirteen of these patients were treated with arthroscopic reduction and fixation. Analysis of the clinical outcome was performed by comparing final range of motion, UCLA and Constant score. Radiological outcome was analyzed with time for union. Postoperative results were analyzed by range of motion, UCLA and constant score. Each figure resulted as: UCLA from 27 to 35 (average: 29); range of motion in forward flexion from 160° to 180° (average: 173°); Constant score from 69 to 100 (average: 73). Using arthroscopic treatment with a suture-bridge technique can be a useful method in terms of clinical and functional outcomes and be considered as a viable alternative to conventional open techniques.