SynthesisInternational orthopaedics2025
Nonoperative versus surgical treatment of displaced midshaft clavicle fractures in adolescents: a systematic review and meta-analysis of comparative studies.
Synthesis in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
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Who cites it
1 citing paper in PubMed.
- Supplementary fixation in multifragmentary midshaft clavicle fractures: do interfragmentary screws or suture cerclage improve outcomes compared with plate-only fixation?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo compare the outcomes and complications of nonoperative versus surgical treatments for displaced midshaft clavicle fractures (MCFs) in adolescents, an area where treatment recommendations remain controversial.
methodsA comprehensive search of PubMed, Embase, and Cochrane databases was conducted to identify studies comparing nonoperative and surgical treatments for adolescent patients with displaced MCFs. Seven studies, including 578 adolescent patients, met the inclusion criteria. Risk ratios (RR) and mean differences (MD) were calculated using a random-effects model. Study quality was assessed using the MINORS tool.
resultsThe risk of nonunion and malunion were higher in the nonoperative group, with RRs of 2.32 (95% CI: 0.26–20.8) and 4.46 (95% CI: 0.8–25), respectively. The surgical group had a higher refracture risk (RR: 0.46, 95% CI: 0.18–1.17). Functional outcomes (DASH scores) showed no significant differences between groups. However, nonoperative treatment was associated with significantly fewer revision surgeries (RR: 0.15, 95% CI: 0.04–0.57) and complications (RR: 0.31, 95% CI: 0.1–0.93).
conclusionsBoth treatment options yielded similar functional outcomes, but nonoperative management was associated with fewer revision surgeries and lower complication rates. Given the absence of significant functional advantage for surgery, nonoperative treatment may be the preferred approach for displaced MCFs in adolescents. LEVEL OF EVIDENCE: Level III, Systematic review of LevelIII studies.
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