Table of Contents
ISRN Orthopedics
Volume 2011 (2011), Article ID 507287, 5 pages
http://dx.doi.org/10.5402/2011/507287
Clinical Study

Effect of Malunited Midshaft Clavicular Fractures on Shoulder Function

1Shoulder Surgery Unit, Department of Orthopaedic Surgery, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
2Institute of Motor Functions, Physical Therapy, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
3Motion Analysis Laboratory, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
4Department of Orthopaedic Surgery, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
5Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel

Received 3 May 2011; Accepted 30 May 2011

Academic Editors: G. C. Babis and K. Yokoyama

Copyright © 2011 Shachar Shapira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Purpose. Displaced middle third clavicle fractures are traditionally treated non-operatively and heal with residual deformity. Few studies assessed treatment success by using patient-oriented outcome measures or objective muscle strength testing. The purpose of our study was to determine whether clavicle malunion affects functional results. Methods. Union was documented in 25 patients who were treated conservatively due to a displaced mid shaft clavicle fracture. Ten had significant malunion. Patients were examined at least 12 months following the fracture. Function was assessed by DASH and UCLA questionnaires. Clinical assessment included Range of Motion (ROM) measurement, manual and isokinetic muscle strength testing. Healthy shoulder served as a control. Results. Mean follow up time was 38 months. The mean DASH score was 9, mean UCLA score was 31.7. Range of motion was preserved—less than 6° side-to-side difference. Abduction strength reduction in the involved side amounted to 7%. No correlation was found between radiographic malunion and the functional results. Interpretation. Displaced healed middle clavicle fractures result in satisfactory functional results. The average deficits detected in strength and ROM were within the normal limits compared to the non-injured side. Radiographic healing position had no effect on functional outcome.