Author | Harris et al. | Alao et al. | Smekal et al. | Austin et al. |
Type of study | Retrospective observational Study | Case series | Retrospective observational Study | Comparative cohort study |
Level of evidence | III | IV | III | II |
Number of patients | 41 pre implementation45 post intervention | 3 | 30 | 50 |
Statistical analysis | None | None | Paired t test or Wilcoxon signed rank test | Kappa analysis for interobserver reliability, Pearson correlation coefficient for intraobserver reliability |
Conclusion | Increased proportion of patients having surgery after introduction of orthogonal views (54% v 67%) | Patients would not have had their clavicle fractures missed and treatment delayed if they had alternative views of clavicle | When compared to CT, PA views of the thorax give the most accurate determination of clavicle length | Surgical treatment more likely with orthogonal views |