In patients with combined clavicle and multiple rib fractures, does fracture fixation of the clavicle improve clinical outcomes?: A multicenter prospective cohort study of 232 patients

Hoepelman, R.J.; Linde, R.A. van der; Beeres, F.J.P.; Beks, R.B.; Sweet, A.A.R.; Lansink, K.W.W.; Wageningen, B. van; Tromp, T.N.; Minervini, F.; Link, B.C.; Veelen, N.M. van; Hoogendoorn, J.M.; Jong, M.B. de; Baal, M.C.P. van; Leenen, L.P.H.; Groenwold, R.H.H.; Houwert, R.M.; IJpma, F.F.

doi:doi:10.1097/TA.0000000000004001

Persistent URL of this record https://hdl.handle.net/1887/3753865

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$In patients with combined clavicle and multiple rib fractures, does fracture fixation of the clavicle improve clinical outcomes?$

Hoepelman, R.J.; Linde, R.A. van der; Beeres, F.J.P.; Beks, R.B.; Sweet, A.A.R.; Lansink, K.W.W.; ... ; IJpma, F.F. (2023)

In patients with combined clavicle and multiple rib fractures, does fracture fixation of the clavicle improve clinical outcomes? A multicenter prospective cohort study of 232 patients

Article / Letter to editor

BACKGROUND: Clavicle and rib fractures are often sustained concomitantly. The combination of injuries may result in decreased stability of the chest wall, making these patients prone to (respiratory) complications and prolonged hospitalization. This study aimed to assess whether adding chest wall stability by performing clavicle fixation improves clinical outcomes in patients with concurrent clavicle and rib fractures.METHODS: A prospective multicenter study was performed including all adult patients admitted between January 2018 and March 2021 with concurrent ipsilateral clavicle and rib fractures. Patients treated operatively versus nonoperatively for their clavicle fracture were matched using propensity score matching. The primary outcome was hospital length of stay (HLOS). Secondary outcomes were intensive care unit length of stay, duration of mechanical ventilation, pain, complications, and quality of life at 6 weeks and 12 months of follow-up.RESULTS: In total, 232 patients...Show moreBACKGROUND: Clavicle and rib fractures are often sustained concomitantly. The combination of injuries may result in decreased stability of the chest wall, making these patients prone to (respiratory) complications and prolonged hospitalization. This study aimed to assess whether adding chest wall stability by performing clavicle fixation improves clinical outcomes in patients with concurrent clavicle and rib fractures.METHODS: A prospective multicenter study was performed including all adult patients admitted between January 2018 and March 2021 with concurrent ipsilateral clavicle and rib fractures. Patients treated operatively versus nonoperatively for their clavicle fracture were matched using propensity score matching. The primary outcome was hospital length of stay (HLOS). Secondary outcomes were intensive care unit length of stay, duration of mechanical ventilation, pain, complications, and quality of life at 6 weeks and 12 months of follow-up.RESULTS: In total, 232 patients with concomitant ipsilateral clavicle and rib fractures were included. Fifty-two patients (22%) underwent operative treatment of which 39 could be adequately matched to 39 nonoperatively treated patients. No association was observed between clavicle plate fixation and HLOS (mean difference, 2.3 days; 95% confidence interval, -2.1 to 6.8; p = 0.301) or any secondary endpoint. Eight of the 180 nonoperatively treated patients (4%) had a symptomatic nonunion, for which 5 underwent secondary clavicle fixation.CONCLUSION: We found no evidence that, in patients with combined clavicle and multiple rib fractures, plate fixation of the clavicle reduces HLOS, pain, or ( pulmonary) complications, nor that it improves quality of life. (Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)STUDY TYPE: Therapeutic/Care Management; Level III.Show less

Rib fracture

clavicle fracture

combined clavicle and rib fractures

costoclavicular fractures