التفاصيل البيبلوغرافية
| العنوان: |
Non-Operative Versus Operative Treatment of Z-Type Comminuted Clavicle Fractures in Adolescents: A Prospective Sub-Stratified Cohort Analysis |
| المؤلفون: |
Sabatini, Coleen S., Edmonds, Eric W., Nepple, Jeffrey J., Liotta, Elizabeth S., Hergott, Katelyn, Perkins, Crystal A., Wilson, Philip L., Li, Ying, Ellis, Henry B., Pandya, Nirav K., Pennock, Andrew T., Spence, David D., Willimon, Samuel C., Bae, Donald S., Kocher, Mininder S., Busch, Michael T., Williams, David N., Heyworth, Benton E. |
| المصدر: |
Journal of Orthopaedic Trauma ; ISSN 0890-5339 |
| بيانات النشر: |
Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: |
2024 |
| الوصف: |
Objectives: To compare the clinical, radiographic, and patient-reported outcomes of non-operative and operative treatment of adolescents with comminuted ‘Z-type’ mid-shaft clavicle fractures. Methods: Design: Prospective observational cohort Setting: Eight tertiary-care pediatric centers Patient Selection Criteria: Patients 10 to 18 years-old who were treated either operatively or non-operatively for a diaphyseal clavicle fracture between 2013 and 2017 were screened/enrolled at the time of injury. The current sub-cohort analysis was derived from a larger adolescent clavicle study population of 907 patients. Outcome Measurements and Comparisons: Complications and validated patient-reported outcome measures (PROs):(ASES, QuickDASH, Marx Shoulder Activity Score, EQ-5D, EQ-VAS, and patient satisfaction score) were compared between operative and non-operative cohorts. Results: Eighty-one patients (69 male (85.2%), 12 female; average age 15 years (11.1-18.7); 78 with sports participation (96.2%)), were followed through bony healing and return to sports, while 59 patients (73%) completed two-year follow-up with patient-reported outcomes (PROs), 26 of whom were treated non-operatively and 33 treated operatively. All demographic and fracture characteristics were similar (p>0.05) between the two-year follow-up cohorts except for fracture shortening, which was greater in the operative cohort (23 mm vs 29 mm, p=0.01). After controlling for this potential confounder through both regression and propensity matched sub-group analysis, non-operative versus operative cohorts showed no difference in rates of nonunion (0%), delayed union (0% vs. 2.3%, p=1.0), symptomatic malunion (2.7% vs 0%, p=0.4), refracture (2.7% vs 2.2%, p=1.0), unexpected subsequent surgery (5.4% vs. 11.4%, p=0.45), or clinically significant complications (5.4% vs. 16%, p=0.17). There were no differences in any PROs between cohorts, both before and after controlling for the difference in fracture shortening (all p-values >0.05). Conclusions: In this ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1097/bot.0000000000002821 |
| DOI: |
10.1097/BOT.0000000000002821 |
| الإتاحة: |
https://doi.org/10.1097/bot.0000000000002821Test |
| رقم الانضمام: |
edsbas.6228D2CD |
| قاعدة البيانات: |
BASE |
