Medizinische Universität Graz - Research portal
Selected Publication:
Kummer, C.
Risk Factors for Nonunions in Conservatively Treated Clavicular Fractures. A Retrospective Study at a Level-I Trauma Centre.
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 127
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- Authors Med Uni Graz:
- Advisor:
- Seibert Franz
- Smolle Maria Anna
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- Abstract:
- Background: Fractures of the clavicle are accounting for up to 10% of all fractures and are the most common type of fracture of the pectoral girdle. Treatment strategies include conservative management and surgical options. Clavicular fractures are generally considered benign injuries with excellent healing prognosis and decent functional recovery. However, complications such as nonunion may occur. Usually accompanied by symptoms, nonunions can result in impaired shoulder mechanics, persistent pain, instability, and compression lesions of vascular and nerval structures. Failure of conservative treatment of clavicular fractures has been observed to occur in up to 15% of all patients. The objective of the study relies upon testing the hypothesis that fracture characteristics and patient-related risk factors assessable by the clinician at patient presentation are associated with impaired bone healing and allow to estimate the probability of nonunion if clavicular fracture is treated conservatively. Methods: Patients with conservatively treated clavicular fractures are examined in this retrospective study. The parameters assessed include patient-specific variables, type of conservative treatment, fracture-specific parameters, and radiological features to determine the time span until bony consolidation has taken place. Statistical Methods are used to show association with nonunions after clavicular fracture and to determine risk factors. Results: Among all investigated risk factors, p-values for allergy (0.006), renal insufficiency (0.038), and initial shortening (0.033) reached statistical significance. In logistic regression analysis, we found a significant association between clavicular nonunion and two independent risk factors: allergy (OR 3.12; 95% CI 1.34-7.28) and renal insufficiency (OR, 3.34; 95% CI, 1.09-10.21). Conclusion: A relatively high non-union rate of closed fracture treatment has been reported. This study discovered allergies and renal insufficiency as significant predictors of nonunion. Clinicians may use this information for improved risk assessment and as a support in the decision-making process regarding treatment approaches (conservatively vs. operatively). Limitations of this study include small prevalence and lack of data in some of the examined parameters, making it difficult to produce statistically significant and reliable results.