Comparison of union rates and functional outcomes for displaced mid-shaft clavicular fractures at Bhuj-Kutch: a prospective study

Abstract

<p class="abstract"><strong>Background:</strong> Clavicle fracture usually treated conservatively. There is a rising tendency to treat displaced mid-shaft clavicular fractures with primary open reduction and plate fixation; whether such treatment outcome in enhanced patient outcomes is contentious. The aim of this study was to compare union rates and functional outcomes for displaced mid-shaft clavicular fractures that were treated with either primary open reduction and plate fixation or nonoperative treatment.</p><p class="abstract"><strong>Methods:</strong> Present study was performed at department of orthopedics, Gujarat Adani institute of medical science, Bhuj, Kutch, Gujarat. Ethical clearance was taken from the institutional ethics board and informed consent was obtained from all the participants. In this study, patients who had an acute displaced mid-shaft clavicular fracture were randomized to receive either primary open reduction and plate fixation or nonoperative treatment. Functional evaluation was conducted at 3 months, 6 months, and 1-year with the use of the constant scores. Union was evaluated clinically and radiographically. Complications were recorded and compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> The rate of nonunion was reduced significantly after open reduction and plate fixation as compared with nonoperative treatment. Constant scores were significantly improved after open reduction and plate fixation than after nonoperative treatment; 93.7 versus 85.5. A major complication was found in 34.9% of patients in the conventional group while they were absent in operative group.</p><p><strong>Conclusions:</strong> Open reduction and plate fixation decrease the rate of nonunion after acute displaced mid-shaft clavicular fracture compared with nonoperative treatment and is connected with improved functional outcomes. Open reduction and plate fixation using precontoured locking plate have little implant-related complications.</p>