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

Abstract

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.