SynthesisEFORT open reviews2026
Conservative vs surgical treatment of midshaft clavicular fractures: a systematic review.
Synthesis in EFORT open reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: This systematic review aimed to evaluate the effectiveness of surgical versus conservative management in terms of union rates, functional outcomes and complications. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomised controlled trials published between January 2017 and November 2023 were sourced from MEDLINE, Embase, PubMed and Cochrane databases. Outcomes assessed included union rates, functional scores and complications. Results: Six trials, involving 579 patients with midshaft clavicle fractures, met the inclusion criteria. The union rate was higher in the surgical group (93.3-100%) compared to the conservative group (82-94%). Time to union was significantly shorter for surgical management in two out of three studies reporting this outcome. Shoulder scores revealed short-term improvements in surgical groups but no significant differences at 12 months or longer. Complication rates were comparable: hardware irritation was more frequent in surgical groups, while non-union was more prevalent in conservative management. Only two studies found a statistically significant difference in union rates favouring surgery. Conclusion: Surgical management offers higher union rates and faster recovery but does not demonstrate significant long-term advantages in functional outcomes compared to conservative treatment. Complication rates are similar, with distinct profiles. Clinicians should prioritise patient-centred decision-making, considering individual preferences and clinical contexts, as operative intervention may not significantly enhance long-term outcomes. Further research should perform subgroup analyses to refine management strategies.
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Registered trials
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