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External fixators in the treatment of midshaft clavicle non-unions: a systematic review

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Abstract

Non- or mal-union of the clavicle is reported to occur in up to 15 % of conservatively treated fractures: the purpose of this systematic review is to examine the evidence for the use of external fixation in the treatment of clavicular non-union. We performed a search of MEDLINE and Embase, including all papers using external fixators for the treatment of clavicular non-union. Four papers satisfied our eligibility criteria: three case series and one case–control study. Level of evidence and quality assessment scoring were performed using published methods. Due to the heterogeneity of the study populations and interventions, no attempt at meta-analysis was made. External fixation in hypertrophic non-union of the clavicle, but not atrophic non-union, appears to be a reasonable treatment option. A pragmatic, multicentre, randomised controlled trial comparing external fixation and open reduction internal fixation in the treatment of hypertrophic non-union of the clavicle would be valuable.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, University of Warwick, Coventry, UK

    Tim Barlow

  2. Department of Trauma and Orthopaedics, University Hospital of Coventry and Warwickshire, Coventry, UK

    Piyush Upadhyay

  3. Department of Trauma and Orthopaedics, University Hospital of Stoke, Stoke-on-Trent, UK

    David Barlow

  4. Clinical Sciences Research Laboratories, University Hospitals of Coventry and Warwickshire, Coventry, CV2 2DX, UK

    Tim Barlow

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  1. Tim Barlow
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  2. Piyush Upadhyay
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  3. David Barlow
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Correspondence to Tim Barlow.

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Barlow, T., Upadhyay, P. & Barlow, D. External fixators in the treatment of midshaft clavicle non-unions: a systematic review. Eur J Orthop Surg Traumatol 24, 143–148 (2014). https://doi.org/10.1007/s00590-013-1173-6

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  • DOI: https://doi.org/10.1007/s00590-013-1173-6

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