Evaluation of outcome of surgically treated displaced clavicle fractures

Abstract

Clavicle fracture is the most frequent trauma of the scapular girdle, and involves the midshaft in 4 out of 5 cases. Non-displaced clavicle fractures of whatever location are usually managed non-operatively. Rare open fractures or fractures associated with neurovascular complications are usually managed surgically. High-energy trauma (floating shoulder, shoulder impaction, multiple trauma) may be managed surgically, on a case-by-case basis [1, 2]. This was a prospective study where 50 patients attending Outpatient, casualty and patients admitted with clavicle fractures from January to December 2018 were studied. Totally 50 patients underwent open reduction and plate fixation from January to December 2018 were followed up for a period of 6 months from the date of admission and analyzed both clinically using Constant Murley scoring system and radiologically with serial radiographs. Clavicle fractures were more common on the right side; about 60% of the patients and 40% of patients had fracture on the left side. The majority of trauma was due to road traffic accidents which constituted to 80%, while fall constituted the rest 20%. Of the 50 clavicle fractures, 40 cases in this study are simple fractures and 6 cases are comminuted fracture and 4 cases was segmental clavicle fracture. All patients were followed up on a regular basis and serial X rays were taken. Union was defined as complete cortical bridging between the distal and proximal fragments. All fractures achieved union as determined by the surgeon after radiographic evaluation. The patients with simple displaced fractures united in 9 weeks while in cases of comminuted fracture with butterfly fragment required 13 weeks and segmental fracture required 15 weeks. There were no instances of nonunion.