Verkürzungsfehlstellung des Schlüsselbeins nach diaphysären Klavikulafrakturen: Einfluss auf die patientenorientierte Bewertung der Schulterfunktion

TY - JOUR

T1 - Verkürzungsfehlstellung des Schlüsselbeins nach diaphysären Klavikulafrakturen: Einfluss auf die patientenorientierte Bewertung der Schulterfunktion

AU - Jubel, A

AU - Schiffer, G

AU - Andermahr, J

AU - Ries, C

AU - Faymonville, C

PY - 2016/6

Y1 - 2016/6

N2 - OBJECTIVE: The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities.MATERIAL AND METHODS: The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles.RESULTS: Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001).CONCLUSION: The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.

AB - OBJECTIVE: The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities.MATERIAL AND METHODS: The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles.RESULTS: Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001).CONCLUSION: The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.

KW - Adult

KW - Clavicle/abnormalities

KW - Diaphyses/injuries

KW - Fracture Healing

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient-Centered Care/methods

KW - Shoulder Fractures/diagnosis

KW - Treatment Outcome

U2 - 10.1007/s00113-014-2648-6

DO - 10.1007/s00113-014-2648-6

M3 - SCORING: Zeitschriftenaufsatz

C2 - 25277730

VL - 119

SP - 508

EP - 516

JO - UNFALLCHIRURGIE

JF - UNFALLCHIRURGIE

SN - 0177-5537

IS - 6

ER -