{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:02:08Z","timestamp":1777662128089,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2024,3]]},"abstract":"\n Background:<\/jats:title>\n Nonoperative treatment for clavicle fractures has historically been standard of care, but with a concomitant rise in recent operative fixation for displaced midshaft clavicle fractures (MCF), a re-evaluation of treatment modalities is necessary. The purpose of this study was to compare nonunion rates among operative and nonoperative treatment of closed displaced MCF. Specifically, we assessed the following between operative and nonoperative management: (1) 90-day to 1-year nonunion and malunion incidence; (2) 90-day medical complications; and (3) 90-day to 1-year total costs of care.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n An all-payer national database was retrospectively reviewed for closed displaced MCF from 2010 to 2020 (n = 173\u2009188). Of these, patients undergoing operative fixation within 30 days of a displaced MCF were identified (n = 17\u2009452). Nonoperative displaced MCF patients were matched with operative patients at a 3:1 ratio. Outcomes at 90\u2009days and 1\u2009year included: nonunion, total cost, and complications.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Closed displaced MCF with operative fixation resulted in significantly increased nonunion rates at 1\u2009year compared with nonoperative treatment (3.97% vs 1.63%, odds ratio = 2.50 [2.26-2.77],\n P<\/jats:italic>\n < .001). Kaplan-Meier survivorship and log-rank score demonstrated the same for a 1-year nonunion endpoint (\n P<\/jats:italic>\n < .001). As expected, the operative cohort incurred higher median total costs of care at 90\u2009days ($3255.00 vs $1024.00,\n P<\/jats:italic>\n < .001) and 1\u2009year ($1978.00 vs $4799.50,\n P<\/jats:italic>\n < .001) compared with nonoperative treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our study found higher nonunion incidence after operative fixation of displaced MCF. These results may serve as a catalyst for future high-quality prospective studies comparing treatment options for closed displaced MCF.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/15589447221109908","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T08:18:32Z","timestamp":1663057112000},"page":"294-299","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Operative Versus Nonoperative Treatment for Closed Displaced Midshaft Clavicle Fractures"],"prefix":"10.1177","volume":"19","author":[{"given":"Oliver C.","family":"Sax","sequence":"first","affiliation":[{"name":"Sinai Hospital of Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1553-4641","authenticated-orcid":false,"given":"Ruben","family":"Monarrez","sequence":"additional","affiliation":[{"name":"Sinai Hospital of Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep S.","family":"Bains","sequence":"additional","affiliation":[{"name":"Sinai Hospital of Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott J.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Sinai Hospital of Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8330-5173","authenticated-orcid":false,"given":"John V.","family":"Ingari","sequence":"additional","affiliation":[{"name":"Sinai Hospital of Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2002.126613."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199403000-00016."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1960.03020100014003."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-196805000-00006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00020."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519826961."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2020.01.010."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1444-1."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199811000-00008."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200106000-00019."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2017\/22052.9143."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01184."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3944\/AOTT.2011.2431."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/term.1505."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/ten.TEB.2014.0677."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01364."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01112."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.bot.0000172287.44278.ef."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01999."},{"issue":"7","key":"e_1_3_2_21_2","first-page":"341","article-title":"Acute operative stabilization versus nonoperative management of clavicle fractures","volume":"38","author":"Judd DB","year":"2009","unstructured":"Judd DB, Pallis MP, Smith E, et al. Acute operative stabilization versus nonoperative management of clavicle fractures. Am J Orthop (Belle Mead NJ). 2009;38(7):341-345.","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B8.BJJ-2018-1253.R2."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2019.07.020."},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00786."}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447221109908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447221109908","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447221109908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:22Z","timestamp":1777447702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447221109908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,13]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1177\/15589447221109908"],"URL":"https:\/\/doi.org\/10.1177\/15589447221109908","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,13]]}}}