Abstract: Background and objectives:
Clavicle fracture is one of the most common bony injuries which accounts for 2.6% to 4% of adult fractures and 35% of injuries of shoulder girdle. The annual incidence of midclavicular fracture is 64 per 100 000 population. Breaks of the shaft form 70% to 80% of all clavicular fractures; lateral fractures contribute to 15% to 30% of the total and medial fractures accounts for 3% and are relatively rare. Open clavicular fracture is an absolute rarity, found in only 0.1% to 1% of cases. There are various methods for treating clavicular fractures such as intramedullary K-wire or Steinmann pins and plating. We have taken up this study to gain deeper understanding of the results and problems associated with clavicular fractures and to evaluate the functional outcome after fixation of clavicular fracture with LCP and conservative management.
Materials and methods: The present study was conducted in Department of Orthopaedics at Sri Siddhartha medical college, hospital and Research Center Tumkur during the period from March 2015 and February 2017. In this prospective study, 60 patients between 18 and 60 years of age who had an acute displaced mid-shaft clavicular fracture were randomized to receive either primary open reduction and plate fixation (n = 30) or nonoperative treatment (n = 30). Functional assessment was conducted at 3 months, 6 months, and 1-year with the use of the constant scores. Union was evaluated clinically and radiographically. Complications were recorded and compared.
Results: The rate of nonunion was significantly reduced after nonoperative treatment (none nonunion) as compared with open reduction and plate fixation (two nonunion). Constant scores were significantly better after nonoperative treatment than after open reduction and plate fixation.
Conclusion: Our study shows that nonoperative treatment reduces the rate of nonunion after acute displaced clavicular fracture compared with Open reduction and plate fixation and is associated with better functional outcomes. Open reduction and plate fixation using precontoured locking plate have non union as complication (7% of cases).