International Journal of Orthopaedics Sciences
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International Journal of Orthopaedics Sciences

2019, Volume 5 Issue 2

A comparative study of stabilization of shaft clavicle fractures using intramedullary nailing vs plating

Author(s): Dr. Vishal Sharma, Dr. Paresh Patil, Dr. Nishant K Gaonkar, Dr. Amit Garud and Dr. Somil Choudhary
Abstract: 
Background: Clavicle fractures account for approximately 2–4% of all adult fractures and about half of all fractures in the shoulder girdle. Conservative management poften leads to cosmetic deformities, complications such as axillary pressure sores, upper extremity edema and venous congestion, brachial plexus palsy, worsening of deformity and increased risk for non-union. There are two commonly performed surgical techniques used to repair displaced midshaft clavicle fractures, open reduction and plate fixation and intramedullary nailing. The present study was conducted to evaluate the end results of Mid shaft clavicle fractures treated in Tertiary Care Centre by various surgical modalities and to evaluate the effectiveness of the different modalities of the treatment and their complications.
Materials and Methods: The present study was a Randomized, Prospective study carried out from October 2016 to March 2018 among patients admitted with midshaft clavicle fractures operated with intramedullary nailing and Open reduction and internal fixation with plating, patients were selected which were operated during the study duration at Orthopaedics Department in Krishna Hospital and Medical Research Centre attached to Krishna Institute of Medical Sciences Deemed University, Karad, Satara.
Results: It was observed that majority of patients in Group P (56%) had excellent outcome followed by good outcome (44%) according to DASH Score. In group I, 15 (60%) patients had good outcome followed by fair outcome (36%).However Group I showed poor outcome (4%). The difference among outcome in both groups showed no statistical significance. (P>0.05).
Conclusion: Plate fixation for severely displaced comminuted midshaft clavicle fractures provides excellent results in terms of rigid fixation, rotational stability and maintenance of anatomical length. Intramedullary nailing of simple midshaft clavicle fractures provides a similar result in terms of quick return to activities with a very good cosmetic outcome.
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