Return to sport following clavicle fractures: a systematic review
Introduction This review aims to provide information on the return rates and return times to sport following clavicle fractures.
Sources of data A systematic search of Medline, EMBASE, CINAHAL, Cochrane, Web of Science, PEDro, SPORTDiscus, Scopus and Google Scholar was performed using the keywords ‘clavicle’, ‘clavicular’, ‘fractures’, ‘athletes’, ‘sports’, ‘non-operative’, ‘conservative’, ‘operative’, ‘return to sport’.
Areas of agreement Twenty-three studies were included: 10 reported on mid-shaft fractures, 14 on lateral fractures. The management principles for athletic patients were to attempt non-operative management for undisplaced fractures to undertake operative intervention for displaced lateral fractures and to recommend operative intervention for displaced mid-shaft fractures.
Areas of controversy The optimal surgical modality for mid-shaft and lateral clavicle fractures.
Growing points Operative management of displaced mid-shaft fractures offers improved return rates and times to sport compared to non-operative management. Suture fixation and non–acromio-clavicular joint (ACJ)-spanning plate fixation of displaced lateral fractures show promising results.
Areas timely for developing research Future prospective studies should aim to establish the optimal treatment modalities for clavicle fractures.
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Autor / Fonte:G A J Robertson, A M Wood British Medical Bulletin 2016 August 22