{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:50:53Z","timestamp":1787241053415,"version":"build-2736575974"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001794","name":"The University of Queensland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n The objective of this study was to determine if operative fixation of clavicle fractures in patients with non-operatively treated ipsilateral rib fractures is associated with a lower overall analgesic requirement and improved respiratory function.<\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n A retrospective matched cohort study was conducted involving patients admitted to a single tertiary trauma centre having sustained a clavicle fracture with ipsilateral rib fracture\/s between January 2014 and June 2020. Patients were excluded if brain, abdominal, pelvic, or lower limb trauma was identified. 31 patients with operative clavicle fixation (study group) were matched 1:1 to 31 patients with non-operative management of the clavicle fracture (control group) based on age, sex, number of rib fractures and injury severity score. The primary outcome was the number of analgesic types used, and the secondary outcome was respiratory function.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study group required a mean of 3.50 types of analgesia prior to surgery which decreased to 1.57 post-surgery. The control group required 2.92 types of analgesia, reducing to 1.65 after the date of surgery in the study group. A General Linear Mixed Model indicated that the intervention (operative vs. non-operative management) had statistically significant effects on the number of required analgesic types (\n p<\/jats:italic>\n \u2009<\u20090.001,\n \n \n $$\\eta_{{\\text{p}}}^{2}$$<\/jats:tex-math>\n \n \n \u03b7<\/mml:mi>\n \n p<\/mml:mtext>\n <\/mml:mrow>\n 2<\/mml:mn>\n <\/mml:msubsup>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula>\n \u2009=\u20090.365), oxygen saturation (\n p<\/jats:italic>\n \u2009=\u20090.001,\n \n \n $$\\eta_{{\\text{p}}}^{2}$$<\/jats:tex-math>\n \n \n \u03b7<\/mml:mi>\n \n p<\/mml:mtext>\n <\/mml:mrow>\n 2<\/mml:mn>\n <\/mml:msubsup>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula>\n \u2009=\u20090.341, 95% CI 0.153\u20130.529) and temporal decline in daily supplemental oxygen requirement (\n p<\/jats:italic>\n \u2009<\u20090.001,\n \n \n $$\\eta_{{\\text{p}}}^{2}$$<\/jats:tex-math>\n \n \n \u03b7<\/mml:mi>\n \n p<\/mml:mtext>\n <\/mml:mrow>\n 2<\/mml:mn>\n <\/mml:msubsup>\n <\/mml:math>\n <\/jats:alternatives>\n <\/jats:inline-formula>\n \u2009=\u20090.626, 95% CI 0.455\u20130.756).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study supported the hypothesis that operative clavicle fixation reduces short-term in-patient analgesia use and improves respiratory parameters in patients with ipsilateral rib fractures.<\/jats:p>\n <\/jats:sec>\n \n Level of evidence<\/jats:title>\n Level III therapeutic study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00402-023-04952-5","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T09:05:00Z","timestamp":1688979900000},"page":"6561-6567","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clavicle fixation to reduce short-term analgesia and improve respiratory function in patients with chest wall injuries"],"prefix":"10.1007","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9902-0815","authenticated-orcid":false,"given":"Helena","family":"Franco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Manzanero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schuetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"4952_CR1","unstructured":"Hyland S, Charlick M, Varacallo M (2021) Anatomy of shoulder and upper limb. In: Clavicle (ed) StatPearls Publishing, Treasure Island, Florida, PMID: 30252246. Bookshelf ID: NBK525990"},{"issue":"1","key":"4952_CR2","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/1749-7922-8-36","volume":"8","author":"J van Laarhoven","year":"2013","unstructured":"van Laarhoven J, Ferree S, Hjowert M, Hietbrink F, Verleisdonk E, Leenen LPH (2013) Demographics of the injury pattern in severely injured patients with an associated clavicle fracture: a retrospective observational cohort study. World J Emerg Surg 8(1):36","journal-title":"World J Emerg Surg"},{"key":"4952_CR3","doi-asserted-by":"publisher","first-page":"3513","DOI":"10.1007\/s00068-021-01701-4","volume":"48","author":"AAR Sweet","year":"2021","unstructured":"Sweet AAR, Beks RB, FFA IJ et al (2021) Epidemiology of combined clavicle and rib fractures: a systematic review. Eur J Trauma Emerg Surg 48:3513\u20133520","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"1","key":"4952_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2106\/JBJS.F.00020","volume":"89","author":"Society COT","year":"2007","unstructured":"Society COT (2007) Non-operative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Jt Surg Am 89(1):1\u201310","journal-title":"J Bone Jt Surg Am"},{"issue":"5","key":"4952_CR5","doi-asserted-by":"publisher","first-page":"595","DOI":"10.21614\/chirurgia.112.5.595","volume":"112","author":"A Langenbach","year":"2017","unstructured":"Langenbach A, Pinther M, Krinner S et al (2017) Surgical stabilization of costoclavicular injuries\u2014a combination of flail chest injuries and a clavicula fracture. Chirurgia (Bucur) 112(5):595\u2013606","journal-title":"Chirurgia (Bucur)"},{"issue":"1","key":"4952_CR6","first-page":"8","volume":"67","author":"B Solberg","year":"2009","unstructured":"Solberg B, Moon C, Nissim A, Wilson M, Margulies D (2009) Treatment of chest wall implosion injuries without thoracotomy: technique and clinical outcomes. J Trauma 67(1):8\u201313","journal-title":"J Trauma"},{"issue":"1","key":"4952_CR7","first-page":"10","volume":"27","author":"BP Cunningham","year":"2020","unstructured":"Cunningham BP, Bosch L, Swanson D et al (2020) The floating flail chest: acute management of an injury combination of the floating shoulder and flail chest. J Orthop Trauma Rehabil 27(1):10\u201315","journal-title":"J Orthop Trauma Rehabil"},{"issue":"5","key":"4952_CR8","doi-asserted-by":"publisher","first-page":"e917","DOI":"10.3928\/01477447-20160623-06","volume":"39","author":"DS Weinberg","year":"2016","unstructured":"Weinberg DS, Napora JK, West WH, Grimberg DC, Vallier HA (2016) Factors associated with narcotic use after clavicle fractures. Orthopedics 39(5):e917-923","journal-title":"Orthopedics"},{"issue":"3","key":"4952_CR9","first-page":"303","volume":"74","author":"B Chalidis","year":"2008","unstructured":"Chalidis B, Sachinis N, Samoladas E, Dimitriou C, Christodoulou A, Pournaras J (2008) Acute management of clavicle fractures. A long term functional outcome study. Acta Orthop Belg 74(3):303\u2013307","journal-title":"Acta Orthop Belg"},{"issue":"4","key":"4952_CR10","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.surg.2005.07.022","volume":"138","author":"BT Flagel","year":"2005","unstructured":"Flagel BT, Luchette FA, Reed LR et al (2005) Half-a-dozen ribs: the breakpoint for mortality. Surgery 138(4):717\u2013723","journal-title":"Surgery"},{"issue":"1","key":"4952_CR11","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.injury.2021.08.029","volume":"53","author":"F Williamson","year":"2022","unstructured":"Williamson F, Warren J, Cameron CM (2022) Rib fractures in blunt chest trauma: factors that influence daily patient controlled opiate use during acute care. Injury 53(1):145\u2013151","journal-title":"Injury"},{"issue":"13","key":"4952_CR12","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.2106\/JBJS.M.00607","volume":"96","author":"T Leroux","year":"2014","unstructured":"Leroux T, Wasserstein D, Henry P et al (2014) Rate of and risk factors for reoperations after open reduction and internal fixation of midshaft clavicle fractures: a population-based study in Ontario. Canada J Bone Joint Surg Am 96(13):1119\u20131125","journal-title":"Canada J Bone Joint Surg Am"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-023-04952-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-023-04952-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-023-04952-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T10:31:16Z","timestamp":1695983476000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-023-04952-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":12,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["4952"],"URL":"https:\/\/doi.org\/10.1007\/s00402-023-04952-5","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]},"assertion":[{"value":"11 January 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"There are no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval was obtained by the authors\u2019 institution Human Research Ethics Committee (HREC\/2020\/QRWB\/72070).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}