Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures : Journal of Orthopaedic Trauma

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Original Article

Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures

Das, Avishek MRCS; Rollins, Katie E. MRCS; Elliott, Kathleen MRCS; Johnston, Philip MD, FRCS (Tr and Orth); van-Rensburg, Lee FRCS (Tr and Orth); Tytherleigh-Strong, Graham M. FRCS (Tr and Orth); Ollivere, Benjamin J. MD, FRCS (Tr and Orth)

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Journal of Orthopaedic Trauma 28(3):p 119-123, March 2014. | DOI: 10.1097/BOT.0b013e3182a2968e



Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before union.


Prospective comparative case series.


Level 1 regional trauma center.


Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included: 68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.


Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3–12 weeks) fixation of displaced clavicle fractures.


Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.


There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.


Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.

Level of Evidence: 

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.


In the article that appeared on page 119 of the March 2014 issue of the Journal of Orthopaedic Trauma, there is an error related to the statistical significance reported in the Results section. Though the data is correctly reported in the Results, Conclusion, and Table 3, the p values listed for the mean QuickDASH score at final follow-up are incorrect. The correct information is as follows: “The mean QuickDASH score at final follow-up was 8.9 in the early fixation group and 9.1 in the delayed fixation group (p > 0.05). The Oxford Shoulder score was 44.2 in the early fixation group and 43.9 in the delayed fixation group (p > 0.05).”

Journal of Orthopaedic Trauma. 29(5):e193, May 2015.

© 2014 by Lippincott Williams & Wilkins

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