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Fractured clavicle in adults: do all patients need follow up

IntroductionMost patients with mid-shaft and medial third fracture of the clavicle are treated non-operatively. They also have a low incidence of complications, both early and late. This does raise the question of whether they need to be followed-up in the hospital. AimTo find out if any change in management occurred during the follow-up visits of patients with fractures of the middle-third or medial-third of the clavicle, and whether they had any complications, or were re-referred after discharge from the hospital. MethodWe performed a retrospective study on 199 patients to see how often they were followed-up, and whether any change occurred in their management during the hospital follow-up visits. The patients were divided into low-energy and high energy fracture groups. ResultsFifty nine percent (59.66%) of patients had a low energy fracture, and the majority of these patients (91.55%) had 2–4 follow-up visits without any change in their management. There was no record of any early complications in the series, and only one patient had a non-union (0.8%). DiscussionSeveral studies had shown that even with a shortening of 1.5 cm or more, there is little effect on the long-term functioning of the shoulder joint. None of the patients from the low-energy fracture group returned to the hospital, for at least six months after discharge, with problems related to their injury. ConclusionThis group could have been safely discharged after their first orthopaedic consultation.


Kalpesh Shah, Suzanne Mason

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