Upper Limb Disability after Treatment in Robinson Type Iib1 Clavicle Fractures in a Secondary Care Hospital

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Published: Jan 28, 2026
DOI: https://doi.org/10.47191/ijmscrs/v6-i1-24
Keywords:
Clavicle fracture, QuickDASH , surgical treatment, conservative treatment, Robinson IIB1.

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Montaño-Salvador CA
Family Physician of HGR no. 1 of Orizaba OOAD Ver-Sur
Flores-Alejandre A
Resident Physician 4 of Traumatology and Orthopedics of the HGR no. 1 of Orizaba OOAD Ver-Sur

Abstract

Introduction: Robinson type IIB1 clavicle fractures are the most common mid-clavicular fractures, and their management remains a subject of debate. While conservative treatment has historically been the first choice, recent evidence suggests functional advantages of surgical management.


Objective: To compare upper limb disability after conservative and surgical treatment in type IIB1 clavicle fractures in a secondary level hospital.


Materials and methods: This was an observational, cross-sectional, analytical, and prospective study conducted between March 2025 and August 2025. Patients aged 18–40 years with type IIB1 fractures treated conservatively or surgically were included. Functional disability was assessed at six months using the QuickDASH scale. Student's t-test was used to compare means; p < 0.05 was considered significant.


Results: One hundred patients were analyzed: 86% male, with a mean age of 29.3 years. The predominant mechanism of injury was traffic accident (76%). The mean QuickDASH disability score was 8.68 in the conservative group and 8.14 in the surgical group. The difference was not statistically significant (t=1.23; p=0.224).


Conclusions: Surgical treatment resulted in less upper limb disability compared to conservative management, although the difference did not reach statistical significance. Clinically, surgery may offer slightly better functional recovery in type IIB1 displaced fractures.

Article Details

How to Cite
CA, Montaño-Salvador, and Flores-Alejandre A. 2026. “Upper Limb Disability After Treatment in Robinson Type Iib1 Clavicle Fractures in a Secondary Care Hospital”. International Journal of Medical Science and Clinical Research Studies 6 (01):164-68. https://doi.org/10.47191/ijmscrs/v6-i1-24.
Issue
Vol. 6 No. 01 (2026): Volume 06 Issue 01 January 2026
Section
Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

References

I. Myeroff C, McKee MD. Clavicle Fractures. Evidence-Based Orthopedics : Second Edition . 2023;469–73.

II. O'Neill BJ, Hirpara KM, O'Briain D, McGarr C, Kaar TK. Clavicle fractures: a comparison of five classification systems and their relationship to treatment outcomes . Int Orthop . 2011;35(6):914.

III. Sea JL, Zuabi N, Wray A. Adult Clavicular Fracture Case Report . Journal of Education & Teaching in Emergency Medicine. 2020;5(4):V11.

IV. Rudez J, Zanetti M. Normal anatomy , variants and pitfalls on shoulder MRI. Eur J Radiol . 2008;68(1):25–35.

V. Matsumura N, Nakamichi N, Ikegami H, Nagura T, Imanishi N, Aiso S, et al. The function of the clavicle on scapular motion : a cadaveric study . J Shoulder Elbow Surg . 2013;22(3):333–9.

VI. Wong M, Kiel J. Anatomy , Shoulder and Upper Limb , Acromioclavicular Joint . StatPearls [Internet]. 2023 Jul 24 [ cited 2024 Jun 23]; Available from : https://www.ncbi.nlm.nih.gov/books/NBK499858/

VII. Kostecki B, Jurek A, Klocek K, Hajduk A, Mrozek Ł, Zwolski M, et al. Clavicle fractures - epidemiology , biomechanics of injury and treatment methods . Journal of Education , Health and Sport. 2023;14(1):216–32.

VIII. Toogood P, Horst P, Samagh S, Feeley B. Clavicle Fractures: A Review of the Literature and Update on Treatment . Physiology Sportsmed . 2011 Sep 1;39:142–50.

IX. Flores D V., Goes PK, Gómez CM, Umpire DF, Pathria MN. Imaging of the acromioclavicular joint : Anatomy , function , pathologic features , and treatment . Radiographics . 2020;40(5):1355–82.

X. Kihlström C, Hailer NP, Wolf O. Is the Robinson classification of clavicle fractures accurate enough within the setting of the Swedish Fracture Register ? Injury . 2023;54(6):1625–9.

XI. Stegeman SA, Fernandes NC, Krijnen P, Schipper IB. Reliability of the Robinson classification for displaced comminuted clavicular midshaft fractures. Cline Imaging . 2015;39(2):293–6.

XII. Song HS, Kim H. Current concepts in the treatment of midshaft clavicle fractures in adults . Cline Shoulder Elb . 2021;24(3):198.

XIII. Sambandam B, Gupta R, Kumar S, Maini L. Fracture of distal end Clavicle : A review . J Clin Orthop Trauma. 2014;5(2):73.

XIV. Morales-Villanueva J, Tamayo-Pacho F, Pineda-Castro O. Complex fractures of the lateral third of the clavicle. Acta Ortop Mex . 2018;32(3):140–4.

XV. Khan LAK, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle . J Bone Joint Surg Am. 2009;91(2):447–60.

XVI. Alito A, Fenga D, Tropeano G, Milardi D, Leonetti D, Migliorato A, et al. Screw Stress Distribution in a Clavicle Fracture with Plate Fixation : A Finite Element Analysis . Bioengineering . 2023;10(12):1402.

XVII. Lenza M, Taniguchi LFP, Ferretti M. Figure-of- eight bandage versus arm sling for treating middle-third clavicle fractures in adults : study protocol for a randomized controlled trial. Trials . 2016;17(1):229.

XVIII. Goel S, Deshpande SV, Jadawala VH, Suneja A, Singh R. A Comprehensive Review of Postoperative Analgesics Used in Orthopedic Practice . Cureus . 2023;15(11):e48750.

XIX. Lenza M, Buchbinder R, Johnston R V., Ferrari BAS, Faloppa F. Surgical versus conservative interventions for treating fractures of the middle third of the clavicle . Cochrane Database Syst Rev. 2019;2019(1).

XX. Ying H, Wang J, Sun Y, Dai K, Yu C, Yang F. Treatment of unstable distal clavicle fractures ( Neer type IIb ): a modified system using a miniature locking plate with a single button . J Int Med Res. 2021;49(6):1–10.

XXI. Horn R, Hendrix JM, Kramer J. Postoperative Pain Control. StatPearls . 2024 Jan 30 [ cited 2024 Jun 23]; Available from : https://www.ncbi.nlm.nih.gov/books/NBK544298/

XXII. Müller ME, Allgöwer M, Willenegger H. Technique of Internal Fixation of Fractures. Technique of Internal Fixation of Fractures. 1965;

XXIII. Dhole S, Mahakalkar C, Kshirsagar S, Bhargava A. Antibiotic Prophylaxis in Surgery : Current Insights and Future Directions for Surgical Site Infection Prevention . Cureus . 2023;15(10).

XXIV. Thomas JD, Kehoe JL. Bone Nonunion . StatPearls . 2023 Mar 6 [ cited 2024 Jun 23]; Available from : https://www.ncbi.nlm.nih.gov/books/NBK554385/

XXV. Bancsi A, Houle SKD, Grindrod KA. Shoulder injury related to vaccine administration and other injection site Events . Canadian Family Physician . 2019;65(1):42.

XXVI. Javed H, Olanrewaju OA, Owusu FA, Saleem A, Pavani P, Tariq H, et al. Challenges and Solutions in Postoperative Complications : A Narrative Review in General Surgery . Cureus . 2023;15(12):e50942.

XXVII. Levy O, Haddo O, Massoud S, Mullett H, Atoun E. A Patient-derived Constant-Murley Score is Comparable to a Clinician-derived Score. Cline Orthop Relat Res. 2014;472(1):303.

XXVIII. Susan Muir C, Muir SW, Luciak Corea C, Beaupre L, MScPT Bs. EVALUATING CHANGE IN CLINICAL STATUS: RELIABILITY AND MEASURES OF AGREEMENT FOR THE ASSESSMENT OF GLENOHUMERAL RANGE OF MOTION. N Am J Sports Phys Ther . 2010;5(3):110.

XXIX. Rysstad T, Grotle M, Klokk LP, Tveter AT. Responsiveness and minimalism important change of the QuickDASH and PSFS when used among patients with shoulder Pain . BMC Musculoskeletal Disord . 2020;21(1):328.

XXX. Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm , shoulder and hand questionnaire ( QuickDASH ): validity and reliability based on responses within the full- length DASH. BMC Musculoskelet Disord . 2006;7:44.