Vol. 11, Issue 4 (2025)

Background: Clavicular fractures, constitutes about 2.6% to 5% of all fractures in adults, mostly involving midshaft clavicle. Clavicle fracture management has evolved over the centuries from supervised neglect to internal fixation. Studies have shown better functional outcome with nailing, as it overcomes the complications of the plate fixation significantly. Thus, this comparative study was taken up. Methods: Study was conducted on 72 patients who underwent surgery for mid-shaft clavicle fractures at Manipal hospital, Bangalore from August 2018-August 2019. Patients were divided into 2 groups,36 in each group of plate fixation or nailing, based on the surgeon’s choice. In intramedullary fixation, 2.5mm TENS nail was used. Plate fixation was done with 3.5 mm pre-contoured LC-DCP. Clavicle length measurement was done with help of plain radiographs. Constant shoulder scores were used for evaluation of the functional outcome at each follow up done at 6 weeks, 12 weeks, 6 months and 12 months. Results: Nailing group has a faster recovery compared to the plating group at 6 weeks, mean CSS at 6 weeks was 57.89 in nailing group and 44.78 in plating group. The CSS was compared in both groups based on age, gender, dominance of hand and smoking status of patient, and found to not affect the functional outcome, except in nailing group, the dominant hand side found to be recovered significantly faster at 6 weeks (P value 0.002) and 12 weeks (P value 0.010). Clavicle length restoration was found to be significant in nailing group which was 1.78cm and that of plating group was 1.30cm. Mean operating time in nailing group was 41.53 minutes which was less and that of plating group 80.72 minutes. Mean incision length of plating was 11.5cm and that of nailing was 3.3cm. Conclusion: Nailing is superior in management of mid-third clavicle shaft fractures considering early recovery, smaller incision, less scar, clavicle length restoration, simple procedure and lesser complications than plate fixation