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FUNCTIONAL OUTCOME OF PATIENT WITH

MIDSHAFT CLAVICLE FRACTURES TREATED WITH

OPERATIVE COMPARED WITH NONOPERATIVE IN

HASAN SADIKIN HOSPITAL

FROM JANUARY 2011 DECEMBER 2011

Chendra WJ, Ismiarto YD, Mulyadi D, Irawan MNSB

Department of Orthopaedic and Traumatology

Faculty of Medicine Universitas Padjadjaran

Hasan Sadikin Hospital

Bandung2012

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Introduction

Clavicle fracture: 2,6 12%.1

80% midshaft.1

Frequently: 20

50 yo.1

1. McKee MD. Clavicle Fractures. Dalam: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P. Fractures in Adults. Edisi ke-7.

Philadelphia: Lippincott Williams and Wilkins; 2010. Hlm. 1106 - 1141.

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Introduction

Controversy exists over management of midshaftclavicle fracture

Consists of: Open reduction and internal fixation

Arm sling or figure of-8

Recent studies have shown a higher prevalence ofsymptomatic malunion, nonunion, and poor functionaloutcome after non-operative treatment.

Aim of study:

to compared functional outcome between operative andnon-operative treatment

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Method

Crossectional study:

Clavicle fracture

underwent operative and nonoperative

between january 2011 December 2011

Patients medical record:

Demographyc

DASH score

tabulated & summarized

to facilitate evaluation

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Results

66 patients:

Age 18 - 55 yo

All unilateral midshaft clavicle fracture

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Results

0

10

20

30

40

50

Sex

Male

Female

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Results

0

5

10

15

20

25

30

35

40

Treatment

Operative

Nonoperative

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Results

Treated Operative Patients (40 patients):

- DASH score less than 15: 36 patients (90%)

Treated Non-operative Patients (26 patients):

- DASH score less than 15: 19 patients (73%)

Statistical study with independent-Samples T-testshowed Sig(2-tailed) 0,101

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Discussion

Clavicle fractures account for 2,6% to 12% of

all fractures and middle third fractures

account for 80%. The surgical indications for

midshaft clavicle fractures are controversial

because in the past studies described that

most midshaft clavicle fractures can be

successfully treated nonoperatively with someform of immobilization.1

1. McKee MD. Clavicle Fractures. Dalam: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P. Fractures in Adults. Edisi ke-7.

Philadelphia: Lippincott Williams and Wilkins; 2010. Hlm. 1106 - 1141.

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Discussion

Some study showed that operative treatment

results in good functional outcome.

1. McKee MD. Clavicle Fractures. Dalam: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P. Fractures in Adults. Edisi ke-7.

Philadelphia: Lippincott Williams and Wilkins; 2010. Hlm. 1106 - 1141.

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Conclusion

Operative fixation of a displaced fracture of the

clavicle midshaft results in improved functional

outcome compared with nonoperative

treatment but statistically the value were not

significant.

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THANK YOU