Evaluation of outcome of conservative versus operative management in clavicle fracture

Abstract

Background: Clavicle connects thorax to the shoulder girdle and plays an important role in movements at shoulder girdle. Clavicle fracture is a common traumatic injury around shoulder girdle. It can be treated both conservatively and surgically. The present study was undertaken to evaluate benefits and advantages of operative management versus conservative management in clavicle fractures. Methods: 50 patients with clavicular fractures were included. Out of which 25 were treated conservatively and 25 were treated surgically between Oct 2018 to July 2020 in the Department of Orthopaedics, G K General hospital, Bhuj, Kachchh, Gujarat. Result: Among 25 patients treated surgically with locking compression plate, 20 patients had fracture union in less than 11 weeks, 2 patients had implant failure (plate loosening) and 3 patients ended up with delayed union. Out of 25 conservatively treated patients, 14 patients had union between 13-16 weeks, 5 patients had union after 18 weeks and 6 patients had non-union. The functional outcome according to Constant and Murley score after fracture union in surgically treated clavicle fractures were excellent in 19 patients, good in 4 patients and fair in 2 patients.Conclusion: In our study we found that in displaced or comminuted middle third clavicle fracture, internal fixation with plate and screws showed early union compared to conservative methods and also having advantages of early mobilization and good functional outcome.