Cochrane · systematic review · CD009363
Surgical versus conservative interventions for treating fractures of the middle third of the clavicle
Lenza, M, Buchbinder, R, Johnston, RV, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
6
current version
GRADE rated
6
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 33.3%Low 4 · 66.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySurgical versus conservative interventions for treating fractures of the middle third of the clavicle
Population: adults with acute fracture of the middle third of the clavicle
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Function (overall) Various toolsa; higher values mean better function (0 to 100 scale, 100 is best function) Surgical vs conservative interventions | no estimate extracted | 10 studies · 838 participants | Low Downgraded: risk of bias, inconsistency |
Pain VAS: 0 to 100 mm (0 is no pain and 100 mm is the worst score) Surgical vs conservative interventions | no estimate extracted | 3 studies · 277 participants | Low Downgraded: risk of bias, imprecision |
Treatment failuref Indication for non‐routine secondary surgery Surgical vs conservative interventions | RR 0.32 [0.2, 0.5] | 12 studies · 1197 participants | Low Downgraded: risk of bias, imprecision |
Cosmetic problemi Surgical vs conservative interventions | RR 0.55 [0.31, 0.98] | 11 studies · 1130 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Total of participants with adverse event outcomel Surgical vs conservative interventions | RR 1.34 [0.68, 2.64] | 14 studies · 1317 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related quality of life: SF‐36 or SF‐12 physical component score at 1 year (0 to 100 points, 100 is best) Surgical vs conservative interventions | no estimate extracted | 2 studies · 321 participants | Low Downgraded: risk of bias, imprecision |
Surgical versus conservative interventions for treating fractures of the middle third of the clavicle
Population: Patients with fracture of the middle third of the clavicle
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Function (overall) Various tools Surgical vs conservative interventions | SMD 0.46 | 7 studies · 429 participants | Low Downgraded: risk of bias, inconsistency |
Treatment failure (indication for non‐routine secondary surgery) Surgical vs conservative interventions | RR 0.38 [0.15, 0.99] | 5 studies · 437 participants | Low Downgraded: risk of bias, inconsistency |
Pain (Visual analogue scale: 0 to 100 points) Surgical vs conservative interventions | no estimate extracted | 1 study · 51 participants | Low Downgraded: risk of bias, inconsistency |
Cosmetic result ‐ total of cosmetic problems Surgical vs conservative interventions | RR 1.16 [0.34, 4.01] | 7 studies · 437 participants | Very low Downgraded: risk of bias, inconsistency |
Infection and/or dehiscence Surgical vs conservative interventions | RR 6.11 [1.1, 33.84] | 3 studies · 218 participants | Low Downgraded: risk of bias, inconsistency |
Hardware irritation requiring removal Surgical vs conservative interventions | RR 5.75 [1.53, 21.65] | 5 studies · 329 participants | Low Downgraded: risk of bias, inconsistency |
Quality of life Not measured Surgical vs conservative interventions | no estimate extracted | NR | No studies |