SynthesisClinics (Sao Paulo, Brazil)2015
Operative versus nonoperative treatment for displaced midshaft clavicle fractures: a meta-analysis based on current evidence.
Synthesis in Clinics (Sao Paulo, Brazil), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 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
23 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Conservative vs surgical treatment of midshaft clavicular fractures: a systematic review.EFORT open reviews · 2026Pooled it
- Pooled it
- Surgical versus conservative interventions for treating fractures of the middle third of the clavicle.The Cochrane database of systematic reviews · 2019Pooled it
- Pooled it
- Pooled it
- Functional Outcomes and Complications of Non-surgical Management for Midshaft Clavicle Fractures.Cureus · 2025Article
- Clinical effect of nice knot-assisted minimally invasive titanium elastic nail fixation to treat Robinson 2B midshaft clavicular fracture.BMC musculoskeletal disorders · 2024Article
- Screw Stress Distribution in a Clavicle Fracture with Plate Fixation: A Finite Element Analysis.Bioengineering (Basel, Switzerland) · 2023Article
- Trends in and Factors Associated With Surgical Management for Closed Clavicle Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Pseudoaneurysm of the subclavian artery as a delayed complication of a clavicle fracture.BMJ case reports · 2023Article
- Displaced Midshaft Clavicular Fractures among Patients with Clavicular Fracture Admitted to the Orthopaedic Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2023Article
- Closed midshaft clavicle fractures : an evidence-based triage management algorithm.Bone & joint open · 2022Article
- DO THE CHANGES OF SCAPULOTHORACIC ANGLE AFFECT WINGED SCAPULA DEVELOPMENT AND FUNCTIONAL SCORES DURING CLAVICLE FRACTURE TREATMENT?Acta ortopedica brasileira · 2022Article
- Return to Full Function in Patient with Nonoperative Management of a Comminuted, Displaced Clavicle Fracture: A Case Report.Orthopedic reviews · 2022Article
- Three-dimensional imaging, modeling, and printing in the correction of a complex clavicle malunion.JSES international · 2021Article
- Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures.BMC musculoskeletal disorders · 2021Article
- Plate Osteosynthesis or Figure-of-Eight Brace: Which One Is Better in Midshaft Clavicle Fractures?Cureus · 2021Article
- Midshaft Clavicle Fractures Treated Nonoperatively Using Figure-of-Eight Bandage: Are Fracture Type, Shortening, and Displacement Radiographic Predictors of Failure?Diagnostics (Basel, Switzerland) · 2020Article
- Functional outcomes, union rate, and complications of the Anser Clavicle Pin at 1 year: a novel intramedullary device in managing midshaft clavicle fractures.JSES international · 2020Article
- Is Insurance Status Associated with the Likelihood of Operative Treatment of Clavicle Fractures?Clinical orthopaedics and related research · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Literature searches of the Cochrane Library, PubMed, EMBASE, Web of Science, LILACS, China National Knowledge Infrastructure, and Wanfang Data databases were performed from 1966 to September 2014. Only randomized and quasi-randomized controlled clinical trials comparing operative and nonoperative treatments for displaced midshaft clavicle fractures were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Thirteen studies were considered in the meta-analysis. Constant scores and the Disabilities of the Arm, Shoulder and Hand scores were improved in the operative fixation group at a follow up of one year or more. The nonunion and symptomatic malunion rates were significantly lower in the operative group. Additionally, the nonoperative group had a higher likelihood of neurological symptoms compared with the operative group. A significantly higher risk of complications was found in patients treated conservatively than in those who underwent operative fixation. However, when patients with nonunion and symptomatic malunion were excluded from the analysis, no significant differences in the complication rate were found. We concluded that based on the current clinical reports, operative treatment is superior to nonoperative treatment in the management of displaced midshaft clavicle fractures. However, we do not support the routine use of primary operative fixation for all displaced midshaft clavicle fractures in adults.
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