# SHORTENING OF CLAVICLE FRACTURES: PHYSICAL VERSUS IMAGE EXAMINATIONS

## TL;DR

This study compares physical and imaging methods to assess bone shortening in clavicle fractures, finding that while CT is most reliable, X-rays are sufficient for surgical decisions.

## Contribution

The study introduces a comparative analysis of physical and imaging methods for evaluating clavicle fracture shortening, highlighting the reliability of CT and adequacy of X-rays.

## Key findings

- Metric tape measurements tended to overestimate bone shortening compared to imaging methods.
- X-ray and CT showed similar results with moderate agreement (Kappa 0.65).
- Fractured clavicles showed similar measurements across methods, but this similarity was likely due to chance or error.

## Abstract

Determine the reliability of three different methods of evaluating bone shortening in displaced midshaft clavicle fractures (DCMF).

A cross-sectional analytical study evaluated bone shortening by metric tape (MT), radiography (X-ray), and computed tomography (CT). Twenty-six men had been evaluated and used clavícula not broken as control. The collection of data was of the blind type for three specialists. Differences and reliability were analyzed with the Friedman and Kappa tests and validated with the T-test (CI: 95%; significance index p<0.05; Software "R" version 3.2.2).

The MT measurements (control) showed abnormal distribution and significant statistical difference concerning the imaging tests (p=0.000008). There was a similarity between X-ray and CT and Kappa agreement of 0.65. The fractured clavicles presented similar measurements between the three methods (p=0.059), and the T-tests proved that the similarity was caused by chance or possible measurement errors.

Measurement by metric tape showed a tendency to overestimate bone shortening. The CT showed more reliable results for the diagnosis; however, the X-ray was sufficient for decision-making by surgeons, and therefore, it is not possible to rule out the importance of this resource for DCMF.
Level of Evidence IV; Case-Control Study.