Is intramedullary nailing more effective than non-operative treatment in adults with displaced middle-third clavicle fractures?

Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

Table 7 Summary table of the reviewed papers based on PICO methodology [23]

Study	Population	Intervention	Comparison	Stated outcome/findings
Paper 1: Smekal et al. [19]	112 participants (age 18–65)	Elastic stable intramedullary nailing (n = 60)	Non-operative management (sling) (n = 52)	IMN demonstrated significantly (P < 0.05) better shoulder function at 2 years follow-up, faster time-to-union, lower non- and delayed union rates and less clavicular shortening
Paper 1: Smekal et al. [19]	112 participants (age 18–65)	Elastic stable intramedullary nailing (n = 60)	Non-operative management (sling) (n = 52)	No significant difference in the total number of complications between groups
Paper 2: Judd et al. [65]	57 participants (aged 17–40)	Intramedullary nailing (Hagi pin) (n = 29)	Non-operative management (sling) (n = 28)	IMN demonstrated significantly (P < 0.04) superior SFS at 3 weeks
				Higher overall complication rate (though significance testing not performed)
				No significant difference in union rates
Paper 3: Smekal et al. [66]	60 participants (aged 18–65)	Elastic stable intramedullary nailing (n = 30)	Non-operative management (sling) (n = 30)	IMN demonstrated significantly (P < 0.05) better SFS, less shortening, fewer complications and shorter time-to-union