Evidence map›Paper›PMID 41680117›Full record

ArticleClinics in shoulder and elbow2026

Impact of routine upright clavicle radiographs on clavicle fracture management.

Joshua Ungar, Andrew Burcke, Saksham Pruthi, Sahand Fallahi, Beau Chandler, Andrew Schlager, Thomas Revak

Abstract read
In one paragraph

Article in Clinics in shoulder and elbow, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Joshua UngarDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Andrew BurckeDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Saksham PruthiDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Sahand FallahiDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Beau ChandlerDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Andrew SchlagerDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Thomas RevakDepartment of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aimed to determine whether increased vertical displacement on upright clavicle radiographs (UCR) compared with supine clavicle radiographs (SCR) influenced the decision to operate.

methodsAdult patients with clavicle fractures identified on initial SCR or computed tomography scans during primary evaluation at a level 1 trauma center from July 2021 to November 2023 were included. The patients also underwent UCR. Exclusion criteria were patients with chronic or pathologic fractures, inadequate imaging, or incomplete documentation. Increases in vertical displacement from SCR to UCR were measured, and we recorded how often these increases on UCR prompted surgical management.

resultsOverall, 160 patients (average age 47.0 years; 70% male) met the inclusion criteria. Most of the study population was managed nonoperatively (90%), with only 16 patients (10%) managed surgically. Only two of the 160 patients (1.3%) underwent surgical intervention based primarily on increased vertical displacement on UCR. With an average change of 4.5 mm (95% CI, 3.5-6.6 mm) between SCR and UCR for patients managed nonoperatively, and 5.1 mm (95% CI, 2.7-7.5 mm) for those managed operatively. There was no significant difference in management based on UCR (P=0.71). Subgroup analysis, stratifying patients by either ≥1 cm or <1 cm of displacement, found there was still no statistically significant change in SCR and UCR (P=0.44).

conclusionsInpatient UCR rarely alters the management of clavicle fractures at our institution, indicating that its use is best reserved for case-by-case consideration. Level of evidence: IV.

Indexed as

ClavicleFracture displacementUpright radiograph

Identifiers

PMID41680117
PMCPMC12982875

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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.