OBJECTIVES: It is unclear whether all completely displaced midshaft @entity174 require primary surgical intervention. The aim of this study was to elucidate the radiological and clinical outcomes after conservative treatment, and to identify subgroups at risk of an inferior outcome. DESIGN: Retrospective case series. SETTING: Level II @entity130 center. @entity1 : Between 2005 and 2008, 122 @entity1 were conservatively treated for a completely displaced midshaft clavicle @entity174 of whom 92 were eligible for inclusion in this study. Of these, 59 completed the study after a median of 2.7  years after the @entity174 (min-max, 1.1-4.9). INTERVENTION: The @entity1 received the standard treatment administered at our institution at the time: nonsurgically with a sling without physiotherapy. @entity1 with @entity158 nonunions were subsequently offered surgery. MAIN OUTCOME MEASUREMENTS: At follow-up, the @entity1 ' Disabilities of Arm, Shoulder, and Hand (DASH) and the Constant scores were evaluated. Radiographs were taken at follow-up and compared to those taken acutely. RESULTS: Nonunion was found in 9 of the 59 (15.3  %) @entity1 . Twenty-four (24  %) @entity1 reported a fair-to-poor DASH score (i.e. >20). @entity1 with @entity174 that were vertically displaced by more than 100  % (one bone width) were significantly less satisfied than those with @entity174 vertically displaced at 100  % (p  =  0.04). Initial shortening of more than 15  mm was not associated with a worse outcome or nonunion. The odds ratio of developing a nonunion increased with age (p  =  0.04). CONCLUSIONS: By treating completely displaced midshaft @entity174 conservatively with a sling and offering plate fixation for eventual @entity158 nonunions, we found a 24  % risk of a fair or poor clinical result with a DASH score over 20. A vertical displacement of more than 100  % between the main fragments on the initial radiograph was associated with an inferior clinical outcome in this study. LEVEL OF EVIDENCE: IV.

Radiological and functional outcomes 2.7  years following conservatively treated completely displaced midshaft XXXX .

@entity130 :: ('MESH:D014947', 'Disease') :: ['trauma'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity158 :: ('MESH:D010146', 'Disease') :: ['painful'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture', 'clavicle fractures']
@entity174 :: (MESH:D050723,Disease) :: ['clavicle fractures']
