Return to sport following clavicle fractures: a systematic review

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IntroductionThis review aims to provide information on the return rates and return times to sport following clavicle fractures.Sources of dataA systematic search of Medline, EMBASE, CINAHAL, Cochrane, Web of Science, PEDro, SPORTDiscus, Scopus and Google Scholar was performed using the keywords ‘clavicle’, ‘clavicular’, ‘fractures’, ‘athletes’, ‘sports’, ‘non-operative’, ‘conservative’, ‘operative’, ‘return to sport’.Areas of agreementTwenty-three studies were included: 10 reported on mid-shaft fractures, 14 on lateral fractures. The management principles for athletic patients were to attempt non-operative management for undisplaced fractures to undertake operative intervention for displaced lateral fractures and to recommend operative intervention for displaced mid-shaft fractures.Areas of controversyThe optimal surgical modality for mid-shaft and lateral clavicle fractures.Growing pointsOperative management of displaced mid-shaft fractures offers improved return rates and times to sport compared to non-operative management. Suture fixation and non–acromio-clavicular joint (ACJ)-spanning plate fixation of displaced lateral fractures show promising results.Areas timely for developing researchFuture prospective studies should aim to establish the optimal treatment modalities for clavicle fractures.

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