External Fixation in the Treatment of Displaced Midshaft Clavicle Fractures in Adults: A Retrospective Study

Abstract

The study aims to compare the clinical outcome of External Fixation (EF) and Plating Fixation (PF) in the treatment of displaced midshaft clavicle fractures in adults. Fifty-nine patients meeting the inclusion criteria were selected; 29 cases of external fixation and 30 cases of open-reduction plate fixation. The average follow-up period was 32 months. Outcomes analysis included: satisfaction with the received treatment, local appearance and shoulder function; residual symptoms; Constant Shoulder Score (CSS); Disability of the Arm, Shoulder and Hand Score (DASH). 25 cases of EF and all patients in PF group were successfully followed up. No statistically significant differences were observed between two groups in overall satisfaction (P=0.12), CSS (P=0.132), DASH (P=0.113), or healing time (P=0.086). In the EF group, there was one case of nonunion (4%) and three cases of angular deformity. PF group had one case of nonunion (3%) and no malunion; hardware irritation and the need for a second surgery were the biggest complications. Compared with PF, EF provided a better treatment overall, with the advantages of simple procedure, no damage to the soft tissue and blood supply, a short healing time, and no second operation.