A comparative study of displaced midshaft clavicle fracture managed by precontoured locking compression plates and titanium elastic nails

Abstract

Background: Results of conservatively managed mid-shaft clavicle fractures are not as good as previously thought. This has lead to increasing interest in primary fixation of these fractures. There are two main techniques of internal fixation, namely, plate fixation and intra-medullary nail fixation. We have evaluated pre-contoured locking compression plates and titanium elastic nails for fixation of mid-shaft clavicle fractures and compared their results. Material and Methods: Between July 1st 2015 and June 30th 2017 42 cases of unilateral displaced mid-shaft clavicular fracture were studied. 23 were managed by open reduction internal fixation with pre-contoured locking compression plates and 19 were managed by closed or open reduction and internal fixation by Titanium Elastic nails. Patients were followed up monthly for 4 months and at 6 months and 9 months. Final results were computed at end of 6 months. Functional outcome was compared using Constant Score. Other complications like non-union, delayed union, infection, implant failure, hardware prominence, refracture and wound dehiscence were also studied. Results: There was significant difference in constant score of two group with plating group performing better. Nail impingement was major concern after intra-medullary nailing. Union time was slightly better in nailing group. Conclusion: Pre-contoured locking compression plates gave better functional outcome and were associated with complications in fewer cases as compared to titanium elastic nails when used for surgical fixation of displaced mid-shaft clavicle fractures.