Six studies were included in the review, with a total of 412 patients (sample size range: 51 to 111). Detsky quality scores were 16 in four studies and 14 in two, out of a possible 20.
The mean Constant Shoulder Score (from three studies) was 94.3 in the operative group and 90.2 in the non-operative group. The mean DASH score (from two studies) was 4.9 in the operative group and 10.7 for conservative care. Data from one study found that 80% of operative patients had returned to moderate activity within 60 days, compared to 55% of non-operative patients.
Complications were less common in the operative group, but the result was not statistically significant (RR 0.70, 95% CI 0.42 to 1.18; Ι²=69%; five studies). Non-union rates were lower in the operative group (RR 0.18, 95% CI 0.06 to 0.51; Ι² = 0; five studies), as were non-union and symptomatic malunion rates combined (RR 0.11, 95% CI 0.04 to 0.29; Ι²=0; five studies).