Functional outcome and complications of open reduction and internal fixation with plate for displaced midshaft clavicle fractures

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Introduction: The purpose of the present study is to evaluate functional outcomes and complications associated with open reduction and internal fixation (ORIF) with plates for displaced midshaft clavicle fractures. Materials and Methods: A retrospective review was performed utilising hospital database for patients treated with ORIF with plate for displaced mid-shaft clavicle fracture from January 2016 to August 2018. The primary outcome measure was union. The secondary outcome measures were functional outcome (DASH), patient satisfaction with treatment and cosmetic appearance, pain, complications and reoperations. All selected patients were requested to attend out-patient department (OPD) for assessment of patient oriented functional outcome measures. Results: Thirty patients were included in the study. Eighty percent were male patients with male female ratio of 4:1, with an average age of 35years. Forty percent fractures were Robinson type 2B1 and 60% were type 2B2. All patients treated with ORIF had fracture union (ie union rate of 100%) at an average time of 7.9 weeks. Patient satisfaction rate was 83%. Mean DASH Score was 14.63 6.27. The complication rate was 33.33%. The common complications were reoperation rate (30%), symptomatic hardware (23.33%), implant failure (6.66%) and superficial infection (3.33%). Conclusion: Open reduction and internal fixation for displaced, midshaft clavicle fracture results in high rates of union and patient satisfaction, and improved functional outcome. Symptomatic hardware removal remains the most common cause of reoperation. Patients with complications reported significantly worst functional outcome scores than patients without complication. Keywords: Clavicle fracture, Mid-shaft, Plate fixation, Functional outcome, Union, Reoperations, Complications.