Abstract
BACKGROUND: This study assessed functional status in shoulders of patients treated conservatively for clavicular shaft fractures with mid-term follow-up. We also compared clinical and radiological outcomes between patients with ≥20 mm and ≤19 mm shortening. METHODS: We retrospectively evaluated 62 patients with clavicular shaft fractures in 2010-2019, categorizing them into 2 groups based on shortening. We assessed various parameters using radiographs and magnetic resonance imaging (MRI), including joint arthrosis and angles. Functional aspects were evaluated using the QuickDASH, Constant Murley scores, and the presence of scapular dyskinesis. RESULTS: Among 62 patients (mean follow-up: 5.2 years), 32 had ≥20 mm shortening (mean: 27.5 ± 6.88 mm), while 30 had ≤19 mm (mean: 12.8 ± 5.4 mm). No correlations were found between critical shoulder angle, clavicle length, and shortening. However, a moderate correlation existed between shortening and unaffected side clavicle length (rho: 0.509, P < .001). Mean unaffected clavicle length was greater in patients with ≥20 mm shortening (172.5 ± 20.9) compared to those with ≤19 mm shortening (156.1 ± 13.4) (P = .014). No differences were observed between the injured sides of the groups based on MRI findings (P > .05). Moreover, there were no significant differences in the presence of scapular dyskinesia, QuickDASH scores, or Constant Murley scores between the injured and unaffected sides in both groups (P > .05). CONCLUSION: Conservative treatment of clavicle fractures in selected cases yields significantly good clinical and radiological outcomes. Irrespective of the amount of shortening, MRI showed more bursitis and tendinitis on the fractured side. At mid-term follow-up, shortening of ≥20 mm cannot be used as a poor prognostic criterion, neither radiologically nor clinically.