Abstract
Introduction: Clavicle fractures account for 2-4% of all fractures occurring in the adults and 69-82% of the clavicular fractures occur in the middle shaft. Out of the operative management techniques, plate fixation and intramedullary nailing with Titanium Elastic Nail (TEN) are commonly used nowadays for internal fixation of displaced diaphyseal clavicle fractures. Objectives: 1. To analyze the differences in functional outcome of each of the two surgical procedures namely plate fixation and TENS Materials and Methods: This Prospective, Non-randomized, two arm, concurrent parallel, experimental study was conducted among 50 patients with type 2B and 2B1 displaced diaphyseal clavicle fracture who underwent either of the two types of surgical fixation of the clavicle fractures which include Group A: compression locking plate fixation and Group B: Intramedullary nailing (TENS). A detailed history including socio-demographic details and medical events prior to surgery was obtained and recorded in a proforma. Follow-up details and operative notes were recorded later during the course of stay in the hospital. the functional outcomes were assessed and compared using modified Murley score and DASH score. Results: The mean age of the study participants was 32.9 ± 12.8 years. Majority of the study participants were males (92%) compared to a very small proportion of females (8%). Majority of patients with type 2B fracturesunderwent TENS (62.5%) whereas most of those with type 2B1 fractures underwent plate fixation (61.5%). Three patients who underwent TENS had radiological union at 6 weeks compare to other patients who had radiological union in 4 weeks. Patients underwent plate fixation encountered implant breakage (n=2, 8%); those underwent TENS had cord injury (n=1, 4%), nail protuberance (n=3, 12%) and infection (n=1, 2%) as complications. Among the participants 8 (32%) in the plate group and 11 (44%) in the TENS group had excellent Murley score. The mean DASH score was not significantly between the plate fixation (7.95 ± 0.9) and TENS (7.92 ± 1.9) surgical groups. Conclusion: The study established that plate fixation was a better surgical technique with good functional outcomes and lesser complications when compared to TENS. Keywords: Displaced diaphyseal clavicle fractures, TENS, plate fixation.
Highlights
Clavicle fractures account for 2-4% of all fractures occurring in the adults and 69-82% of the clavicular fractures occur in the middle shaft
The middle third of the clavicle is more prone for fractures which is evident from the fact that 69-82% of the clavicular fractures occur in the middle shaft
[3] Out of these operative techniques, plate fixation and intramedullary nailing with Titanium Elastic Nail (TEN) are commonly used nowadays for internal fixation of displaced diaphyseal clavicle fractures
Summary
Clavicle fractures account for 2-4% of all fractures occurring in the adults and 69-82% of the clavicular fractures occur in the middle shaft. Out of the operative management techniques, plate fixation and intramedullary nailing with Titanium Elastic Nail (TEN) are commonly used nowadays for internal fixation of displaced diaphyseal clavicle fractures. [3] Out of these operative techniques, plate fixation and intramedullary nailing with Titanium Elastic Nail (TEN) are commonly used nowadays for internal fixation of displaced diaphyseal clavicle fractures. Plate fixation of clavicle fractures is a gold standard technique which has been in vogue for many years. It has a few disadvantages like extensive periosteal stripping increasing the destruction of the blood supply at the fracture site, thereby hindering fracture healing. Stress shielding produced by rigid plates can lead to an 8% refracture rate after plate removal. [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
