Plate fixation versus elastic nailing for displaced clavicle fractures: A comparative study

Abstract

Background: A prospective comparative study carried out to compare the efficacy of intramedullary nailing and plate fixation, for displaced midshaft clavicular fracture, over each other.Materials and Methods: 62 patients with midshaft clavicle fracture were randomly divided into the plating group (31 patients) and the nailing group (31 patients). Post operative assessment was done and outcomes were compared between the groups throughout the follow up period of 1 year in terms of union rate, cosmesis, functional score and complications.Results: Incision length (p=0.008), operative time (p=0.02), blood loss (p=0.003) and hospital stay was significantly less for the nailing group as compared to the plating group. Implant failure, non union and hypertrophic scar was more prevalent in the plating group. The Constant Murley score was significantly higher for the nailing group (p=0.04) in the initial 6 months of the follow up, however there was no statistically significant difference in the DASH score (p=0.42) and Constant score beyond 6 month follow up.Conclusion: Intramedullary nailing is a superior alternative to plate fixation for clavicle fracture because of less complications, less hospital stay, better cosmesis and functional outcome.