Home > DARE Reviews > Operative versus nonoperative treatment...

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review

Review published: 2013.

Bibliographic details: Rehn CH, Kirkegaard M, Viberg B, Larsen MS.  Operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review. European Journal of Orthopaedic Surgery and Traumatology 2013: epub. [PubMed: 24322539]

Abstract

OBJECTIVES: Intervention studies of clavicle fracture treatment are numerous, but only a few high quality studies prospectively compare operative and nonoperative treatment. The objective of this study was to review evidence from randomized controlled trials on operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults with focus on fracture healing, complications and functional outcome.

DATA SOURCES: An electronic search was performed of PubMed, Embase and Cochrane databases which revealed 559 articles. All articles published before October 18th 2012 and written in English, Danish or Swedish were eligible.

STUDY SELECTION: Articles were excluded if they included children under the age of 16, did not include acute midshaft fractures, included concomitant fractures, did not meet the requirements of Level I evidence according to Centre for evidence based medicine 2009 guidelines, were systematic reviews or meta-analyses, or did not compare operative and nonoperative treatment.

DATA EXTRACTION: Articles were parsed for relevance by two reviewers independently regarding title, abstract, and full text. Extraction of data was done by both reviewers in collaboration and sorted according to the aims of the study. Complications were grouped according to additional surgery required. The quality of studies was assessed by both reviewers in unison using Critical Appraisal Skills Programme 2010 checklists.

CONCLUSIONS: It seems like operative intervention leads to fewer nonunions at the cost of an increase in minor complications compared to nonoperative treatment. However, the effects of operation on functional outcome remains controversial. High quality evidence is currently sparse supporting either operative or nonoperative treatment on displaced midshaft clavicle fractures in adults.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 24322539

Download

PubMed Health Blog...

read all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...