Surgical treatment of displaced middle-third XXXX : a prospective, randomized trial in a working compensation population.

@entity1 @entity130 @entity174
BACKGROUND: Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third @entity174 resulted in shorter complete return to work periods with earlier consolidation documented on computed tomography (CT) scans in this prospective, randomized controlled trial. METHODS: The study randomized 76 consecutive @entity1 with displaced @entity174 (2B1-2B2 according to Robinson) to conservative (C, n =  42) and surgical (S, n  =  34) treatment with plates and screws. Bone union was documented with CT scans at 6 and 12 weeks. RESULTS: Risk factors known to increase the risk of nonunion were similar between groups. Time until discharge for complete return to work was 3.7      1.1 months for C and 2.9      0.8  months for S (P  =  .003). On the CT scan at 6 weeks, 24.1% of the @entity1 presented advanced bone union in S vs 5.3% in C (P  =  .05). At 12 weeks, 81% of the @entity1 presented advanced bone union in S vs 16.7% in C (P  =  .005). At final follow-up, 4 nonunions were present in the C group that required surgery; in the S group, 4 @entity1 underwent revision surgery for plate removal. At 6 and 12 months of follow-up, Constant scores were higher for the S group. CONCLUSIONS: Surgical treatment with ORIF of displaced middle-third @entity174 achieved good and excellent functional results, shorter time to complete return to work, earlier bone union, and fewer cases of nonunions in a working population under @entity130 .
