2025 ISAKOS Biennial Congress ePoster
Return to Sport After ORIF with Plate Fixation of Clavicular Fracture: A Systematic Review and Meta-Analysis
Grace Johnston, BS UNITED STATES
Philip Serbin, MD, Dallas, Texas UNITED STATES
Claire Noyes, BS, Denver, CO UNITED STATES
Carson Keeter, MS, Aurora, Colorado UNITED STATES
Eric C. McCarty, MD, Englewood, CO UNITED STATES
Rachel M. Frank, MD, Englewood, CO UNITED STATES
University of Colorado, Denver, Colorado, UNITED STATES
FDA Status Not Applicable
Summary
This is a meta-analysis identifying return to sport rate in self-identified athletes after plate fixation for mid shaft and lateral clavicular fractures.
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Abstract
Objectives
This review aims to provide an overview of the literature on return to sport outcomes following open reduction internal fixation (ORIF) for clavicular fractures in the athlete population.
Methods
This systematic review and meta-analysis was conducted by an individual researcher screening through three databases: PubMed, Cochrane Library and Embase. Twelve studies were included with 542 patients that defined themselves as athletes aged 31.87 +/- 9.27 years treated surgically with ORIF for a mid-shaft or lateral third clavicular fracture. The mean follow-up time was 26.7 months with a range of 5-79.2 months. Patient reported outcomes: Constant-Murley Score (CMS), Visual Analog Scale (VAS), and Quick Disability of the Arm, Shoulder and Hand (QuickDASH) score assessed shoulder function. Return to sport time, level and rate were reported as well.
Results
In the overall meta-analysis for return to sport (RTS) at any level, there were 12 studies with a total of 434 patients who returned to any level of sports. In the overall meta-analysis for return to sport at pre-injury level, there were 8 studies with a total of 329 patients who returned to pre-injury level of sport. There were 503 mid-shaft fractures, 15 lateral-third fractures, and 25 were a mix of either fracture type. The lateral third fractures were categorized as a mix of type Neer I-III. Mean CMS 91.25 +/- points. Mean QuickDASH score was 16.6 points. Average return to sport (RTS) time was 42.8 days. This was a mix of professional and recreational athletes. There is statistically significant evidence that there is a trend between mean age of patients and RTS (p=0.002). An increase in an athlete's age by one year correlated with an increase in time taken to RTS by 2.7 months.
Conclusion
There is a high rate of return to sport following clavicular fractures in the athlete population. Furthermore, athletes can RTS at their previous injury level following ORIF of both mid-shaft and lateral fractures independent of sport. RTS among recreational athletes and professional athletes is not comparable. However, athlete age and RTS time has been proven comparable.