Operative Versus Nonoperative Treatment In Clinical Practice Of Midshaft Clavicular Fractures: Meta-analysis Of Randomized Controlled Trials

Objective: Meta-analysis was used to evaluate the clinical results of operative versus nonoperative treatment in clinical practice of midshaft clavicular fractures.Methods: Randomized controlled trials comparing clinical results of adult mid-clavicular fractures published 1989-Agu. 2014 were retrieved by computer and manual from databases, including Cochrane Databa, Ovid, Medline, Chinese Biomedical Literature database, China National Knowledge, Articles database, VIP database, et al. The quality of the included studies were evaluated. Rvaman 5.1 was employed to conduct Meta-analysis.Results: 6746 studies were retrieved and eventually seven RCTs were included with a total of 572 cases of mid-clavicular fracture patients. Meta analysis indicated that nickelclad surgical treatment can significantly reduce the rate of nonunion, the rate of residual pain, malunion rate, CS scores(P<0.05). No statistically significant difference was found in delayed healing rate and incidence of neurological complications(P>0.05).Conclusions: Under the same conditions, compared with conservative treatment, nickelclad surgical treatment of adult mid-clavicular fractures has certain advantages, but it is still need to carefully choose clinical solutions.