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Displaced middle-third clavicle fracture management in sport: still a challenge in 2018. Should you call the surgeon to speed return to play?
  1. Greg A Robertson1,
  2. Alexander M Wood2,
  3. Christopher W Oliver1,3
  1. 1 Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2 Orthopaedic Department, Leeds General Infirmary, Leeds, UK
  3. 3 Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Greg A Robertson, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, 51 Little FranceCrescent, Edinburgh EH16 4SA, UK; greg_robertson{at}live.co.uk

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Introduction

The management of clavicle fractures should be guided by fracture location (middle-third/lateral/medial) and fracture configuration (undisplaced/displaced/comminuted).1–5 Current management guidelines recommend surgical management for middle-third fractures, which are completely displaced, shortened by 2 cm or comminuted, as this can facilitate an earlier return to sport and improve final shoulder function.2 3 5

Our systematic review assessed all clavicle fracture studies that recorded return to sport, to determine the effect of different treatment methods on return rates and times to sport.6 Twenty-three studies were included: 8 were prospective cohort studies, 15 were retrospective cohort studies.6

Here we summarise the results from that systematic review, to determine the optimal management of middle-third clavicle fractures. Such information provides sport physicians and surgeons with an evidence-based treatment algorithm for these injuries, allowing optimisation of return rates and times to sport for affected athletes.

Review methodology

The systematic review was collated following a search of: CINAHAL, Cochrane, EMBASE, Google Scholar, Medline, PEDro, Scopus, SPORTDiscus, Web of …

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