Trial reportJournal of orthopaedic trauma2010
Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial.
Trial report in Journal of orthopaedic trauma, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- What Is the Best Evidence for Management of Displaced Midshaft Clavicle Fractures? A Systematic Review and Network Meta-analysis of 22 Randomized Controlled Trials.Clinical orthopaedics and related research · 2020Pooled it
- Surgical versus conservative interventions for treating fractures of the middle third of the clavicle.The Cochrane database of systematic reviews · 2019Pooled it
- Cost-utility studies in upper limb orthopaedic surgery: a systematic review of published literature.The bone & joint journal · 2018Pooled it
- Surgical Versus Conservative Treatments for Displaced Midshaft Clavicular Fractures: A Systematic Review of Overlapping Meta-Analyses.Medicine · 2015Pooled it
- Surgical fixation of displaced midshaft clavicle fractures: elastic intramedullary nailing versus precontoured plating.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2014Trial
- Function plateaus by one year in patients with surgically treated displaced midshaft clavicle fractures.Clinical orthopaedics and related research · 2011Trial
- Displaced midshaft fractures of the clavicle: non-operative treatment versus plate fixation (Sleutel-TRIAL). A multicentre randomised controlled trial.BMC musculoskeletal disorders · 2011Trial
- Trial
- Article
- Ex vivo analysis of cortical microarchitecture of the distal clavicle: implications for surgical management of fractures.Archives of orthopaedic and trauma surgery · 2024Article
- The fifty most-cited articles regarding midshaft clavicle fractures.Journal of orthopaedics · 2023Article
- Healthcare utilization and related cost of midshaft clavicle fracture treatment in Belgium.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Cost-Effectiveness of Operative Versus Non-Operative Treatment for Clavicle Fracture: a Systematic Literature Review.Current reviews in musculoskeletal medicine · 2020Review
- Cost Analysis in Shoulder Surgery: A Systematic Review.Orthopaedic journal of sports medicine · 2020Review
- CORR Insights®: What Is the Best Evidence for Management of Displaced Midshaft Clavicle Fractures? A Systematic Review and Network Meta-analysis of 22 Randomized Controlled Trials.Clinical orthopaedics and related research · 2020Article
- Current concepts in the management of clavicle fractures.Journal of clinical orthopaedics and trauma · 2020Review
- Operative treatment of displaced midshaft clavicle fractures: has randomised control trial evidence changed practice patterns?BMJ open · 2019Article
- Acute Surgery vs. Non-union Surgery of Displaced Midshaft Clavicle Fractures: A Case-control Study.Cureus · 2019Article
- Adolescent Clavicle Fractures: Is There a Role for Open Reduction and Internal Fixation.Current reviews in musculoskeletal medicine · 2019Review
- Midshaft clavicle fractures: Current concepts.EFORT open reviews · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesTo determine the cost-effectiveness of open reduction internal fixation (ORIF) of displaced, midshaft clavicle fractures in adults.
designFormal cost-effectiveness analysis based on a prospective, randomized, controlled trial.
settingEight hospitals in Canada (seven university-affiliated and one community hospital). PATIENTS/
participantsOne hundred thirty-two adults with acute, completely displaced, midshaft clavicle fractures.
interventionClavicle ORIF versus nonoperative treatment. MAIN OUTCOME MEASUREMENTS: Utilities derived from SF-6D.
resultsThe base case cost per quality-adjusted life-year (QALY) gained for ORIF was $65,000. Cost-effectiveness improved to $28,150/QALY gained when the functional benefit from ORIF was assumed to be permanent with cost per QALY gained falling below $50,000 when the functional advantage persisted for 9.3 years or more. In other sensitivity analyses, the cost per QALY gained for ORIF fell below $50,000 when ORIF cost less than $10,465 (base case cost $13,668) or the long-term utility difference between nonoperative treatment and ORIF was greater than 0.034 (base case difference 0.014). Short-term disutility associated with fracture healing also affected cost-effectiveness with the cost per QALY gained for ORIF falling below $50,000 when the utility of a fracture treated nonoperatively before union was less than 0.617 (base case utility 0.706) or when nonoperative treatment increased the time to union by 20 weeks (base case difference 12 weeks).
conclusionsThe cost-effectiveness of ORIF after acute clavicle fracture depended on the durability of functional advantage for ORIF compared with nonoperative treatment. When functional benefits persisted for more than 9 years, ORIF had a favorable value compared with many accepted health interventions.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.