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DO THE CHANGES OF SCAPULOTHORACIC ANGLE AFFECT WINGED SCAPULA DEVELOPMENT AND FUNCTIONAL SCORES DURING CLAVICLE
Mehmet Rauf Koç1,2, İsmail Hakkı Korucu3,4, Mehmet Yucens5,6
1El Cerrahisi Kliniği, Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye.
Acta Ortopedica Brasileira
|July 22, 2022
Summary
Surgical management of midshaft clavicle fractures resulted in better scapulothoracic joint function and fewer deformities compared to conservative treatment. This approach improved shoulder pain and disability scores, offering superior clinical outcomes.
Area of Science:
- Orthopedics
- Traumatology
- Sports Medicine
Background:
- Midshaft clavicle fractures are common injuries requiring effective management strategies.
- Understanding the impact of treatment on scapulothoracic joint mechanics is crucial for functional recovery.
- Previous studies have focused on union rates, but functional and radiological outcomes require further investigation.
Purpose of the Study:
- To compare surgical versus conservative management of midshaft clavicle fractures.
- To evaluate the effects on scapulothoracic joint angle changes.
- To assess clinical, functional, and radiological outcomes, including pain, disability, and deformity.
Main Methods:
- Ninety-five patients (18-70 years) with midshaft clavicle fractures were randomized into conservative (Group I) or surgical (Group 2) treatment.
- Measurements included plane deformities, scapulothoracic joint angle, clavicle shortness, and isokinetic muscle strength.
- Validated outcome measures: Shoulder Pain, Disability Index (SPADI) and Short Form-36 (SF36).
Main Results:
- Higher scapulothoracic joint angles and increased incidence of winged scapula were observed in the conservative group (p=0.036 and p=0.001, respectively).
- Surgical treatment yielded significantly better SF-36 physical scores and lower SPADI pain and disability scores.
- Negative anteroposterior and axial plane deformities, along with clavicle shortness, were more frequent in the conservative group.
Conclusions:
- Conservative management of midshaft clavicle fractures is associated with significant scapulothoracic joint angle changes and a higher prevalence of winged scapula.
- Surgical intervention demonstrates superior outcomes in terms of shoulder function, pain reduction, and radiological alignment.
- These findings support surgical management for midshaft clavicle fractures to optimize functional recovery and minimize complications.
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