Clavicle Fractures In Adults Research Articles

Hook Plate Fixation for Acute Unstable Distal Clavicle Fracture: A Systematic Review and Meta-analysis.

To compare the outcome of hook plate fixation with other techniques in surgical fixation of acute unstable distal clavicle fractures. In July 2018, a systematic search of electronic databases (PubMed, Medline, Embase, and Cochrane databases for systematic reviews) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Articles were limited to English language. Studies were included if they compared the results of hook plate fixation of acute unstable distal clavicle fracture in adults with other surgical techniques. Data on the study setting, functional outcome, union, and complication rates were extracted. A quality assessment was performed using the Newcastle-Ottawa Scale. Eleven studies were found that met the inclusion criteria. Six hundred thirty-four patients were pooled using a random effects model. There were 397 male and 237 female patients. Primary outcome measure was functional result, and the secondary outcome measures were union and complication rates. There was no significant difference between the functional outcome and union rate between hook plate fixation, coracoclavicular (CC) stabilization, and locking plate fixation. Hook plate fixation resulted in a higher Constant-Murley score compared with tension band wiring (TBW) [odds ratio (OR), 3.52; 95% confidence interval (CI), 0.79-6.26]. It was also associated with a higher complication rate compared with CC stabilization (OR, 3.68; 95% CI, 1.19-11.33) and the locking plate (OR, 5.19; 95% CI, 1.58-17.06). Compared with TBW, hook plate fixation was associated with a lower complication rate (OR, 0.28; 95% CI, 0.10-0.77). Hook plate fixation achieves a similar functional outcome and union rate compared with CC stabilization and locking plate fixation. However, it has a superior functional result compared with TBW. The complication rate is higher compared with CC stabilization and locking plate fixation and is lower compared with TBW. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Functional results of clavicle fractures in adults treated by open reduction and internal fixation using superior precontoured plate

Background: Observe results of open reduction and internal fixation of fractures of the clavicle in adults using pre-contoured superior clavicle locking plate.Methods: This study was prospective study carried out in the Govt Medical college Hospital Baramullah Kashmir Department of Orthopaedics from June 2014 to September 2016. A total of 25 patients with fresh fractures were treated with ORIF with a pre-contoured superior clavicle locking plate.Results: The mean age of patient was 30.08 years, males (64%), right clavicle frequently fractured (52%) Robinson type 2B1 configuraion. (44%) sustained their injury due to a road traffic accident. The average 6 month Quick DASH score was 0.82, whereas the mean constant score was 94.8 at final follow-up. The complications were superficial wound infection in (4%), mechanical pull-out of the plate in (8%), numbness below the incision area in (12%), symptomatic hardware in (4%), and non-union in (4%).Conclusions: There has been a resurgence of interest in operative treatment for fractures that are displaced, comminuted, or that display significant shortening. Operative treatment is beneficial to only a subset of patients, in whom functional expectations and fracture characteristics have both been taken into account before taking the final decision.

Complications after surgical treatment of distal clavicle fractures

IntroductionDistal clavicle fractures have low rates of union when treated with conservative measures. Operative treatment is generally recommended for Neer type II and V. Multiple fixation methods exist with no clear gold standard. The goal of the current study is to assess the outcomes and complications of distal clavicle fractures treated with one of three fixation methods: standard clavicular plate, hook plate or suture fixation about the coracoid. MethodsThis is a retrospective cohort study of surgically-treated unstable Neer type II and V distal clavicle fractures in adults. These operations were performed by multiple surgeons within a single healthcare system between January 2010 and September 2012. Patients were divided into three cohorts: pre-contoured clavicular locking plates, hook plates, and suture-only fixation methods. Univariate and mulivariate modeling analyses were performed. ResultsA total of 74 distal clavicle fractures comprised the final cohort. Fifty-eight (77%) of these fractures were Neer type II; the remaining 16 (21.6%) were Neer type V. Median follow-up time was 12 months (range 10–28). BMI, smoking status, diabetes, and ASA class were similar among all cohorts. Twenty-one patients were treated with suture fixation alone (28.3%), 37 with a contoured clavicular plate (50%) and 16 with hook plate fixation (21.6%). Twenty-one patients (28.4%) experienced complications, including two hardware failures requiring revision surgery. A total of 10/16 (62.5%) patients with hook plates required hardware removal for irritation, compared to 6/37 (16.2%) with a contoured clavicular plate (OR=8.61, p value=0.001), and none with sutures alone. A total of 3/21 patients (14.2%) treated with suture fixation methods were diagnosed with adhesive capsulitis post-operatively; no patients in the plate fixation groups received this diagnosis. The Neer V group had a higher proportion of any complications (37.5%) compared to Neer II (25.9%), and a higher rate of stiffness (12.5% v. 1.7% in Neer II). ConclusionThis study compared the outcomes of three different fixation methods for unstable distal clavicle fractures. The overall union rate with any method of operative intervention was very high (98.6%), consistent with previous studies. Hook plates had a much higher re-operation rate, mostly owing to a higher incidence of hardware removal, an expected outcome owing to the prominence of these plates in the subacromial space. Contoured clavicular plates were associated with a lower incidence of irritation and hardware removal than hook plates, although one patient in this group experienced loss of fracture fixation and went on to asymptomatic radiographic non-union. Suture-only fixation methods had the lowest rate of re-operation, with only one of 21 procedures resulting in failure and requiring revision. However, there was a significantly higher rate of adhesive capsulitis in the suture fixation cohort, perhaps due to the tethering effect of the clavicle to the coracoid or violation of the rotator interval. While this study supports that most distal clavicle fracture fixation methods can achieve stable union, there is a highly variable complication profile associated with each fixation method. The routine use of hook plate fixation cannot be recommended.

Clavicle fractures in adults; current concepts.

For decades, clavicle fractures have been treated conservatively. In the last 20years, however, non-union rates after conservative treatment appear higher than previously reported and more evidence regarding operative treatment has become available. This has led to a paradigm shift towards an increase in operative treatment. The aim of this review is to present the current concepts and available evidence regarding clavicle fracture treatment. Conservative and operative treatment options together with their indications for medial, shaft and lateral clavicle fractures are discussed. For all three anatomical locations, a treatment algorithm is proposed. In general, non-displaced fractures are treated conservatively. Operative treatment has to be discussed with patients with displaced clavicle fractures, especially in the young and active patient.

Management of Midshaft Clavicle Fractures in Adults.

Fractures of the clavicle are common injuries that occur across all age groups but are most frequently seen in the young, active patient population. Among the different types of clavicle fractures, those occurring in the middle third of the clavicular shaft are the most common. Historically, most of these fractures were treated by closed means even when notable displacement was present. Recently, there has been a renewed interest in assessing the best treatment option for these patients. Although nonsurgical treatment is a reliable method for treating many of these fractures, more recent data suggest that fractures with notable displacement (>2 cm of shortening or >100% displacement) and/or comminution have better short-term outcomes and lower rates of nonunion with surgical management. Current surgical options include superior plating, anterior-inferior plating, dual plating, and intramedullary nail fixation.

Orthopedic Treatment of Clavicle Fracture in Adulthood at Sylvanus Olympio Teaching Hospital of Lome (Togo): Functional and Anatomical Results

Background: Fractures of the clavicle are relatively frequent and are benign lesions. Their management may be nonoperative or surgical. The objectives of this study were to determine the functional and anatomical outcome of fractures of the adult clavicle after nonoperative treatment. Materials and methods: Two years retrospective study was done. It rolled patients with clavicle fracture treated with either plaster bolero, scarf or clavicular brace with or without rehabilitation, who gave informed consent and who agreed to provide us initial and control radiological pictures. The objective results were evaluated by the Constant score and radiological control images. The subjective results were mainly represented by the impressions of the patients. Results: We recorded 171 cases of clavicle fracture in adults, or 6.2% of fractures in general, including 53 women. The sample studied consisted of 114 cases, including 12 women. In the majority of cases the constant score was either good, 65.8% or excellent, 20.7%. We have not noticed a poor result. Radiologically, the evolution was marked by 90.4% of vicious callus and 2.6% of pseudarthrosis. More than half of the patients, 62.2% were satisfied with the results of the nonoperative treatment received. Conclusion: The evolution of the fractures of the clavicle after nonoperative treatment was therefore favorable on the functional level but marked by vicious callus and pseudarthrosis.

Functional outcome of plating for displaced middle third clavicle fractures in adults

Introduction: Clavicle fractures are the common fractures around the shoulder. Conservative treatment is as­sociated with higher incidence of nonunion. We conducted this study to assess the functional outcome of plat­ing for displaced middle third clavicle fractures. 
 Methods: This prospective study included 60 patients with displaced middle third clavicle fractures from April 2016 to March 2017. Fixation was done with a 3.5 mm reconstruction plate placed at the superior surface of the clavicle. Patients were followed-up for a minimum of one year. Functional outcome was assessed using Constant shoulder score. 
 Results: There were 48 male and 12 female patients with a mean age of 33.17 years (range 18-74 years). The average follow-up period was 17.82 months. All fractures united at an average of 5.35 months. The mean Constant score at final follow-up was 89.12. There were two superficial infections and three implant failures. 
 Conclusion: We conclude that treat­ment of displaced middle third clavicle fracture with plate gives good results.

Is the clavicle fractures fixed with plates and screws really improves the functional outcomes a prospective study

Background: Clavicular fractures account for approximately 2.6% of all fractures. Fractures occur most commonly in the middle third of the bone. Displaced Mid-shaft clavicle fractures are common and are generally treated non-operatively. Non-operative treatment of these fractures with axial shortening is associated with a non union rate of 13 – 18% and a delayed union rate of 25%. Prompt fixation of these clavicle fractures permits increased patient comfort, and early shoulder mobility. Objective: To analyse the functional outcome of surgical management of clavicle fracture fixed with plates and screws in terms of union, functions and complications. Displaced Mid-shaft clavicle fractures are common and are generally treated non-operatively. Methods: A prospective study of 30 cases of midshaft clavicle fractures in adults. Managed surgically during the period from August 2015 to August 2017 satisfying the inclusion and exclusion criteria were studied. The functional outcome was evaluated using the Constant and Murley scoring system. Results: In our study we achieved 90% excellent results and 10% good results. The results were comparable to other studies. Conclusion: In this study demonstrate early pain relief with good shoulder function, quick return to activities and a high patient satisfaction rate. Therefore, we believe that open reduction and rigid internal fixation is a valuable option in the acute treatment of displaced Mid-shaft clavicle fractures in active adults with high functional demands.

Nonoperative Treatment of Midshaft Clavicle Fractures in Adults.

Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature. Most fractures are suitable for conservative treatment. There is solid evidence in favour of nonoperative treatment for fractures with a displacement of less than 2cm and remaining contact of the bone fragments. Clear indications for conservative treatment versus surgical fixation of displaced midshaft fractures have not finally been established yet, leaving some questions and problems unanswered. Furthermore, there are no evidence-based recommendations concerning the kind and duration of shoulder immobilisation with no clear advantage for any treatment modality.

Does anatomic locking compression plate play a vital role in maintaining length of clavicle in comminuted fracture & enhance good functional outcome

Deformity following un-united and mal-united adult clavicle fractures is being increasingly recognised as the indications for operative treatment of displaced fractures of the clavicle. Various options include low contact dynamic compression plates, which are strong, but difficult to contour and cause soft tissue irritation. Recon plates are easier to contour, but lack sufficient mechanical strength. Anatomical Pre-contoured locking plates are now available, matching the shape of the adult clavicle. The purpose of this study is to assess the clinical and radiological outcome of a pre-contoured clavicle plate in the treatment of acute, displaced, mid-shaft clavicle fractures. This study presents the results of 26 patients treated with an anatomical congruent clavicle plate for acute displaced, mid-shaft fractures of the clavicle at a tertiary referral centre. All patients were managed with a precontured clavicle plate. The fracture united in all cases with no complication and high patient satisfaction on the Disability of the Arm and Shoulder (DASH) score and Pain Visual analogue score (VAS). The results were compareble with other published studies, and the pre contured clavicle plate represents one of the best operative management of these fractures.

Clinical outcomes and predictors of patient satisfaction in displaced midshaft clavicle fractures in adults: Results from a retrospective multicentre study

BackgroundThe optimal treatment of displaced midshaft clavicle fractures (Robinson Type 2B1 & 2B2) in adults remains controversial. Little is known about patient satisfaction with treatment for this type of injury. The purpose of this study was to compare clinical outcomes and explore predictors of patient satisfaction after nonoperative and direct-operative treatment of displaced midshaft clavicle fractures in adults. MethodsA retrospective multicentre study was conducted. Clinical data were retrieved from electronic patient charts. A questionnaire informing on current subjective function (QuickDASH), pain levels (VAS), health-related quality of life (Eq-5D-5L), impact on employment and satisfaction with treatment results was sent to all patients. Univariate and multivariate linear regression was performed to identify predictors of satisfaction. ResultsA total of 278 patients were identified (nonoperative n=150, direct-operative n=128). 67% of eligible patients returned the questionnaire. Median questionnaire follow-up was 2.1 years. No differences were found between groups for QuickDASH, Eq-5D-5L or pain VAS scores. Impaired union was observed in 13.2% of nonoperative cases vs. 2.3% in the direct-operative group. Patients in the nonoperative group could resume work after a median of 30.0days, compared to 13.5days in the direct-operative group. Patient satisfaction was higher in the direct-operative group, 8/10 vs. 7/10 for overall treatment results respectively. Patients’ rating for the level of shared decision-making was the main predictor of overall satisfaction. ConclusionDirect-operative management led to higher patient satisfaction, despite similar long-term patient reported outcomes with nonoperative treatment. Patients’ rating for the level of shared decision-making was the main predictor of overall satisfaction. This study highlights the need to enhance communication to facilitate shared decision-making.

Value of 3D printing technique in the treatment of adult displaced clavicle fracture

Objective To investigate the clinical value of 3D printing technique in the treatment of adult displaced clavicle fracture. Methods The clinical data of forty adult patients with displaced clavicle fracture treated in Yan’ an University Affiliated Hospital from January 2016 to December 2016 were retrospectively collected.According to different surgical methods, the patients were divided into group A and group B, with 20 cases in each group.The group A received the CT scan of the uninjured lateral clavicle before operation to obtain the original data.The mimics 17.0 software was used to perform 3D reconstruction and to generate the affected side mirror model.The 3D printer was introduced to print the affected mirror model.According to the model of preoperative planning, minimally invasive surgery was performed under model guidance.The group B (20 cases) was underwent minimally invasive surgery via conventional C arm fluoroscopy.The operation time, blood loss, fluoroscopy times and postoperative hospital stay in the two groups were recorded.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up were recorded. Results All patients received postoperative follow-up for nearly 6 months.The operation time of the two groups were (35.8±11.6) min and (50.1+ 15.5) min (t=3.303, P=0.002), the intraoperative blood loss were (38.4±9.3) ml and (60.3±10.2) ml (t=7.095, P=0.000), respectively, the fluoroscopy times of the two groups were (5.2±1.6) times and (9.7±2.1) times (t=7.622, P=0.000) respectively, the postoperative hospitalization stay were (6.7±0.5) d and (7±0.6) d (t=1.717, P=0.093), the differences were statistically different.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up in both two groups were improved significantly than those in preoperative (P 0.05). Conclusion 3D printing technique assisting minimally invasive surgery for displaced clavicle fractures in adults has the advantages of shorter operation time, less intraoperative blood loss and less fluoroscopy.The clinical follow-up Results are satisfactory. Key words: 3D printing technology; Mirror image model; Clavicle fracture; Minimally invasive surgery

Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults.

ABSTRACTObjective To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches.Methods A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle. Incomplete or inconsistent answers were excluded.Results The type of radiographic classification preferably used was related to description of fracture morphology, according to 41% of participants. Allman classification ranked second and was used by 24.1% of participants. As to indications for surgical treatment, only the indications with shortening and imminence of skin exposure were statistically significant. Conservative treatment was chosen in cortical contact. Regarding immobilization method, the simple sling was preferred, and treatment lasted from 4 to 6 weeks. Although the result was not statistically significant, the blocked plate was the preferred option in surgical cases.Conclusion The treatment of midshaft clavicle fractures in Latin America is in accordance with the current literature.

The Clavicle Trial: A Multicenter Randomized Controlled Trial Comparing Operative with Nonoperative Treatment of Displaced Midshaft Clavicle Fractures.

The treatment of displaced midshaft clavicle fractures remains controversial. We undertook a multicenter randomized controlled trial to compare effectiveness and safety between nonoperative management and ORIF (open reduction and internal fixation) for displaced midshaft clavicle fractures in adults. Three hundred and one eligible adult patients were randomized to 1 of the 2 treatment groups and followed at 6 weeks, 3 months, and 9 months after recruitment. The primary outcome was the rate of radiographically evident nonunion at 3 months following treatment. Secondary outcomes were the rate of radiographically evident nonunion at 9 months, limb function measured using the Constant-Murley Score and DASH (Disabilities of the Arm, Shoulder and Hand) score, and patient satisfaction. There was no difference in the proportion of patients with radiographic evidence of nonunion at 3 months between the operative (28%) and nonoperative (27%) groups, whereas at 9 months the proportion with nonunion was significantly lower (p < 0.001) in the operative group (0.8%) than in the nonoperative group (11%). The DASH and Constant-Murley scores and patient satisfaction were all significantly better in the operative group than in the nonoperative group at 6 weeks and 3 months. Although at 3 months there was no evidence that surgery had reduced the rate of nonunion of displaced midshaft clavicle fractures, at 9 months nonoperative treatment had led to a significantly higher nonunion rate (11% compared with <1%). The rate of secondary surgical intervention during the trial period was 12 (11%) of the 147 patients in the nonoperative group. ORIF is a safe and reliable intervention with superior early functional outcomes and should be considered for patients who sustain this common injury. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Results of Treatment of Displaced Midshaft Clavicle Fractures in Adults by Open Reduction And Internal Fixation - A Case Series

Results of Treatment of Displaced Midshaft Clavicle Fractures in Adults by Open Reduction And Internal Fixation - A Case Series

A clinical study on role of surgical management of clavicle fractures in adults

Clavicle, the horizontal bone of the body fractures is seen commonly in Road traffic accidents, fall from heights and also in simple falls. The clavicle fractures account for about 5-10% of all fractures. Traditionally it is believed that conservative management is best instead of surgery for clavicle bone. Internal fixation for middle third fractures of clavicle with interlocking will not be ideal choice as the implant cannot be precontoured. Fixation with plates would be a better choice for the said situation. Similarly, fixation of lateral third fractures is also better option suggested by many authorities. To analyze methods of surgical management for the fractures of middle and lateral third parts the current study was carried out at Department of Orthopedics, Government Medical College and Hospital, Anantapuramu. An attempt is also made to study the epidemiological factors associated with fracture of the clavicle. At the end of the study it can be concluded that the middle and lateral third fractures of clavicle are common in younger age group males who met with road traffic accidents. As for as surgical management is concerned, internal fixation with plates and screws for middle third fractures and tension band wiring for lateral third fractures of Clavicle would be ideal choice as they allow for early rehabilitation, less chances for infection and pose least number of complications.

Prospective Analysis of Surgical Treatment For Displaced Midshaft Clavicle Fractures in Adults

Background: The traditional view that the vast majority of midshaft clavicular fractures heal with good functional outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. And it is becoming increasingly apparent that clavicular malunion is a distinct clinical entity with radiographic, orthopedic, neurologic, and cosmetic features. Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures.Objective: To analyze the demography of midshaft clavicular fracture and to observe union time, DASH score, and complication of surgical treatment. Materials and Methods: This prospective observational study of 34 cases with midshaft clavicle fracture was conducted in Nepalgunj medical college, Kohalpur in a time span of one year. Patients were treated operatively with plating and followed up at 6 weeks, 12 weeks, 18 weeks, 6 and 12 month.Results: Thirty four patients (Male: 29 Female: 5) with average age 32.95 years (range: 19 to 59 years) were operated for clavicular fracture with male predominance (85.30%). The mean time for fracture healing was 16.24 weeks and mean DASH score was 13.58.Conclusions: Displaced midshaft clavicular fracture can be effectively managed with plating and have improved functional outcome and shorter time for union.JNGMC Vol. 13 No. 2 December 2015, Page: 17-20

Dual fixation of midshaft clavicle fractures in adults: intramedullary Kirschner wire with augmentative plate fixation

Background The clavicle is one of the most commonly fractured bones in the body. In adults, clavicle fractures represent 2.6–5% of all fractures and 44% of all shoulder girdle injuries. Although fracture union usually occurs regardless of the treatment selected, controversy exists regarding optimal management. Although most clavicle fractures can be managed nonoperatively, still there has been debate on how to best treat displaced midshaft clavicular fractures. Without fixation, nonunion rates as high as 15–21% have been reported. Operative fixation for displaced midshaft fractures improve the functional outcomes and decrease nonunion rates. Operative management including open or closed reduction with plate fixation or intramedullary (IM) fixation results in improved outcomes and lower rates of nonunion compared with nonoperative management and is recommended for patients with multiple risk factors for nonunion, especially significant displacement or clavicle shortening. This study was conducted to assess the results and reliability of combined IM and plate fixation of displaced mid-clavicular fractures in adults. Patients and methods Thirty-three adult patients with comparable demographics having displaced mid-clavicular fracture were submitted to surgical fixation by both IM Kirschner wire and short small reconstruction plate. Results were assessed at the end of this period according to Constant and Murley Score (CMS). The CMS is a 100-point functional shoulder-assessment tool in which higher scores reflect increased function. Results At the end of the follow-up period, the mean score was 95.33±9.0. Thirty-two (97%) patients had excellent results, and only one (3%) patient had poor result. The mean final CMS for pain was 14.70±1.74. The mean final CMS for activity of daily living was 19.67±1.91. The mean final CMS for active forward flexion was 9.82±1.04 (145°–174°). The mean final CMS for active abduction was 9.82±1.04 (145°–174°). The mean final CMS for active external rotation was 9.88±0.70. The mean final CMS for active internal rotation was 9.88±0.70. The mean final CMS for strength was 23.88±2.36. Time of union in the studied patients ranged from 8 to 12 weeks, with a mean of 8.25±0.84 weeks. Conclusion Our research data suggest that a relatively new technique using IM Kirschner wire with augmentative anteroinferior short small fragment contoured reconstruction plate fixation is a suitable, reproducible, and effective alternative for surgical fixation of displaced midshaft clavicle fractures in adults and provides reliable functional results.

Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital

Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital

Functional outcome in surgical management of midshaft clavicle fractures fixed with precontoured plate in adults

Background: Fractures of clavicle are one of the most common fractures in traumatic injury around shoulder girdle as the bone is sub cutaneous throughout. Fractures of middle third clavicle generally occur either by high energy or low energy impact. These fractures have been treated traditionally by non-operative methods. Although many close reduction methods have been described it has been recognised that complete reduction is practically impossible. Open reduction and internal fixation have become the mainstay of treatment for most of the midshaft fractures, as these operative methods restores the anatomy, biomechanics and contact loading characteristics of the clavicle. Objectives: To study the functional outcome of surgically managed clavicle fractures with precontoured locking plate. Methods: A prospective study of 60 cases of midshaft clavicle fractures in adults, Managed surgically by open reduction and fixation with precontoured plate during the period from May 2014 to April 2016 satisfying the inclusion and exclusion criteria were studied. The functional outcome was evaluated using the Constant and Murley scoring system. Results: In our study we achieved 93.4% excellent to good results, 5% fair results, 1.6% Poor results. The results were comparable to other studies. Interpretation & Conclusion: The operative results were satisfactory in 93.4% cases, with good to excellent functional outcome. This study shows rigid fixation with precontoured plate and screws for fresh displaced or comminuted middle third clavicle fracture gives good anatomical reduction, immediate pain relief and prevents the development of shoulder stiffness and non-union and thus on the whole shows good functional outcome by early mobilisation and hence patient to their functional activities.