AAOS Appropriate Use Criteria Summary: Treatment of Mid-Shaft Clavicle Fractures.

Abstract

The American Academy of Orthopaedic Surgeons (AAOS) has developed an Appropriate Use Criteria (AUC) for the Treatment of Mid-Shaft Clavicle Fractures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop criteria to determine the appropriateness of surgical and nonsurgical treatment in patients who have suffered a mid-shaft clavicle fracture. The Appropriate Use Criteria for the Treatment of Mid-Shaft Clavicle Fractures were derived by identifying clinical indications typical of patients who have suffered a mid-shaft clavicle fracture. These indications were most often variables observable by the clinician, including symptoms or results of diagnostic tests. In addition, "human factor" (eg, activity level or demographic variables) can be considered. The 96 patient scenarios and two treatments were developed by the writing panel, a group of clinicians who are specialists in this Appropriate Use Criteria topic. Next, a separate, multidisciplinary rating panel (made up of specialists and nonspecialists) rated the appropriateness of treatment for each patient scenario using a 9-point scale to designate a treatment as "Appropriate" (median rating, 7 to 9), "May Be Appropriate" (median rating, 4 to 6), or "Rarely Appropriate" (median rating, 1 to 3).