2025 ISAKOS Biennial Congress ePoster
Surgical or Conservative? Treatment Options for Clavicle Fractures and Analysis of Scapular Dyskinesis
Ulaş Can Kolaç, MD, Ankara TURKEY
Serkan Ibik, MD TURKEY
Taha Aksoy, m.d, ankara TURKEY
Gökhan Ayik, PhD, Ankara TURKEY
Mehmet Kaymakoglu, M.D, Izmir TURKEY
Orhan Mete Karademir, MD, Ankara TURKEY
Dilara Kara, phd, Ankara TURKEY
Irem Duzgun, PhD, Ankara TURKEY
Gazi Huri, Prof. MD, Doha QATAR
Hacettepe University, Ankara, ankara, TURKEY
FDA Status Not Applicable
Summary
This study suggests that conservatively treated clavicle shaft fractures may have a higher, though not statistically significant, incidence of scapular dyskinesis, with surgical treatment potentially leading to better functional outcomes and lower pain levels.
ePosters will be available shortly before Congress
Abstract
Aim
Midshaft clavicle fractures are common and often associated with scapular dyskinesis (ScD), particularly in cases of shortening. While fractures with less than 2 cm shortening are often treated conservatively, emerging evidence suggests that even minor shortening can increase the risk of ScD and impair functional outcomes. This study investigates the impact of surgical versus conservative treatment on ScD and functional recovery.
Methods
A retrospective analysis of 60 patients with isolated midshaft clavicle fractures was conducted. Patients were categorized into surgical and conservative groups. Fracture shortening was assessed using radiographs, outcomes were assessed using the SICK Scapula Rating Scale, Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons Scale and Visual Analog Scale (VAS). Logistic regression and ROC analysis was applied to identify ScD predictors, and critical shortening threshold.
Results
ScD was observed in 43.3% of patients, with a higher incidence in the conservative group (53.6%) compared to the surgical group (34.4%; p = 0.216). Surgical treatment was associated with significantly better SST and VAS scores at the final follow-up (p < 0.05). Logistic regression identified clavicular shortening (p < 0.001) and lower BMI (p = 0.033) as significant predictors of ScD. ROC analysis revealed that a shortening threshold of 0.4 cm had a sensitivity of 73.08% and a specificity of 91.18% for predicting ScD (AUC = 0.874, p < 0.001).
Conclusion
Surgical treatment reduced the prevalence of ScD and facilitated better functional outcomes through early mobilization and anatomical alignment. These findings suggest surgical treatment may benefit patients even in minimally displaced fractures, highlighting the importance of individualized treatment strategies.