Clinico-radiological outcome of fracture middle 3rd clavicle treated non-operatively and with plate osteosynthesis: A comparative study

Abstract

Background: Clavicle fractures are common injuries, accounting for 2.8% of all fractures. Fractures of the middle third account for approximately 80% of all clavicular fractures. Displaced middle 3rd clavicle fractures are typical and are generally treated non-operatively. Non-operative treatment of these fractures with axial shortening is correlated with a non union rate of 13 – 18% and a delayed union rate of 25%. Intractable pain, neurological complications and loss of shoulder function have been noted. Prompt fixation of these clavicle fractures charter increased patient comfort, and early shoulder mobility. We have taken up this study to analyse the results of plate fixation and non-operative treatment for middle third clavicle fractures in terms of time to union, functional improvement and complications.Objectives: To compare results of plate fixation of middle third clavicle fractures with those managed nonoperatively in terms of radiological union and functional outcome.Materials and Methods: This is a prospective comparative study. The duration of study period is 2 years. Cases satisfying the inclusion criteria and who had received treatment either nonoperatively or in the form of plate fixation at Chettinad Hospital and Research Institute based on the patient’s informed decision during the period of Jun 2013 to Feb 2015 were included in the study. Patients were then followed up for a period of up to 9 months (3, 6 & 9 months) and evaluated clinically with Constant and Murley scoring system and with radiographs.Results: There was significant improvement in the rate of fracture union and functional scores in the operated group compared to the nonoperative treatment group.Conclusions: In this prospective study, plate fixation of middle third clavicular fractures resulted in earlier functional recovery and lower complication compared with nonoperative treatment.