Plating for midshaft clavicular fractures: The impact on quality of life and functional outcome

Injury. 2017 Dec;48(12):2778-2783. doi: 10.1016/j.injury.2017.10.032. Epub 2017 Oct 24.

Abstract

Introduction: Several studies report on functional outcome after operative treatment for midshaft clavicular fractures. According to the published data not much is known about the quality of life after operative treatment. The purpose of this study is to investigate long term patient reported quality of life (QoL) and functional outcome after plating for midshaft clavicular fractures.

Methods: Patients between 16 and 65 years of age, with a midshaft clavicular fracture which were treated with plate fixation between 2006 and 2014, were included. Information was extracted from hospital records and all patients were asked to participate in an online survey. Primary outcome was QoL (SF-36 and EQ-5D-5L). Secondary outcomes were complications, reoperation rate, patient- and cosmetic satisfaction, pain, and functional outcome (DASH).

Results: In a retrospective cohort design, 164 patients were included, 101 completed the online survey. Patients reported a good QoL and functional outcome. The mean physical- and mental SF36 score were 53.9±7.3 and 52.3±9.9 (0-100), the EQ-5D-5L score was 0.88±0.17 (-0.59 to 1.0) and the average DASH was 8.45±14.0 (0-100). Furthermore, there was a strong correlation between the functional outcome and QoL (p<0,001). Seventeen patients developed at least one complication (10%) and seventy-seven patients got a reoperation, with isolated implant removal as the leading cause of reoperation (80,5%).

Conclusion: Patients which received operative treatment for a midshaft clavicle fracture have an excellent QoL, and a good functional outcome. Furthermore, there is a strong relationship between functional outcome and the QoL.

Keywords: Functional outcome; Midshaft clavicle fracture; Plate fixation; Quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Bone Plates
  • Clavicle / injuries*
  • Device Removal
  • Female
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Healing
  • Fractures, Bone / physiopathology
  • Fractures, Bone / psychology
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Patient Reported Outcome Measures
  • Patient Satisfaction / statistics & numerical data
  • Postoperative Complications / physiopathology
  • Postoperative Complications / psychology
  • Postoperative Complications / surgery*
  • Quality of Life*
  • Recovery of Function / physiology*
  • Reoperation / psychology
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Young Adult