Improved Functional Outcomes Following Operative Treatment of Midshaft Clavicle Fractures in an Active Duty Population.
| Autor: | Lake N; Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, USA., Mombell KW; Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, USA., Bernstein E; Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, USA., O'Mary K; Orthopaedics and Rehabilitation, University of Texas Medical Branch, Galveston, USA., Scott J; Orthopaedics, Naval Medical Center San Diego, San Diego, USA., Deafenbaugh B; Orthopaedics, Naval Medical Center San Diego, San Diego, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2020 Mar 31; Vol. 12 (3), pp. e7488. Date of Electronic Publication: 2020 Mar 31. |
| DOI: | 10.7759/cureus.7488 |
| Abstrakt: | Clavicle fractures are common orthopedic injuries that occur in a young active population and are even more common in the military. Military fitness test data presents the unique opportunity to analyze functional ability with regard to military-specific activities. The primary goal of this study was to compare functional outcomes using military fitness test data between operative and non-operative treatment of midshaft clavicle fractures. We performed a retrospective review of active-duty U.S. Navy and Marine patients with midshaft clavicle fractures treated at our institution over a seven-year period. There were 94 and 153 patients in our operative and non-operative cohorts, respectively. Average follow-up time from the date of injury or surgery was 28 months. The rate of infection in the operative group (4%) was significantly greater than in the non-operative group (0%, p = 0.023). The rate of non-union in the operative group (3%) was significantly lower than in the non-operative group (14.5%, p = 0.004). The rate of symptomatic malunion in the operative group (0%) was significantly different from that in the non-operative group (4.6%, p = 0.036). There was no significant difference in the rate of revision surgery between the operative (9.2%) and non-operative (13.2%) groups ( p = 0.105). A total of 51 marines met inclusion criteria for our functional outcome analysis using Marine Corps Physical Fitness Test (PFT) data. Of those who underwent operative fixation, 68% were able to meet or surpass their pre-injury average amount of pull-ups in their first PFT after surgery and 88% by the next PFT at least one year after surgery. While 69% of non-operative patients met their pre-injury average in their first PFT, only 57% maintained this level at least one year after surgery. This difference was statistically significant. In our functional outcome subgroup analysis, we found improved outcomes for pull-ups at least one year out when midshaft clavicle fractures are treated operatively compared to non-operatively. While similar findings in the literature are based on functional outcome questionnaires, physical fitness performance data has not been reported on to our knowledge. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Lake et al.) |
| Databáze: | MEDLINE |
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