Fracturas del tercio medio de la clavícula en pacientes laboralmente activos tratamiento quirúrgico versus ortopédico

Abstract

Introduction:. For the treatment of patients with midshaft clavicle fractures, both surgical and nonoperative treatments are available, however, in the local context there is no evidence of which one provides better outcomes. Materials and Methods: Retrospective cohort of patients with midshaft clavicle fractures comparing patients who underwent surgical treatment with patients treated nonoperatively, evaluating esthetics, pain, physiotherapy, labor reimbursement and DASH score after 3 months of treatment, as main outcomes. Results: There were 91 patients treated nonoperatively and 24 patients treated with surgery. The median of age was 34.1 for both groups. 30.2% of patients who underwent surgery presented pain after 3 months, while none of the nonoperative group presented this outcome. 79.1% of patients treated nonoperatively and 20.9% of the surgical group referred esthetical complains. The medians for physiotherapy sessions were 8.04 for nonoperative treatment and 9.04 for surgical treatment. The mean labor reimbursement was 5 weeks for both groups. Discussion: Both surgical and nonoperative treatment showed similar results for all variables that were measured, without being able to conclude which option is better. Patients with initial displacements less than 2 cm are candidates for nonperative treatment, showing good results and DASH scores of 35 after 3 months of treatment. Patients with initial displacements less than 2 cm are frequently treated with surgery, also showing good results and DASH scores of 38 after 3 months of treatment.