Prospective comparative study of functional outcome of displaced midshaft clavicle fractures treated by locking plating versus minimally invasive titanium elastic nail fixation

Abstract

Introduction: The clavicle is the most commonly fractured bone, which accounts for 5–10% of all fractures. More than half of these fractures are displaced.Traditionally clavicle fractures are treated non-operatively. But recent studies show higher rates of nonunion upto 15% and unsatisfactory functional outcomes despite fracture union with conservative management. Operative management of these fractures had better outcomes and a lower rate of nonunion and symptomatic mal union when compared with non-operative treatment.Commonly either plating or nailing is done for middle third clavicle fractures. It is imperative to know the complications and outcomes with both these procedures.Aim: The aim of our study is comparative analysis of outcome of Displaced middle third clavicle fractures in patients treated with plate osteosynthesis and intramedullary tens nail.Materials and Methods: This is a comparative study undertaken in the department of Orthopaedics, Meenakshi Medical College and research institute, Enathur from01/ 09/2017 to 31/08/2018. Within the period of study, 40 patients with displaced middle third clavicle fractures were operated alternatively with Plating and nailing (titanium elastic nail). We had 20 patients who were operated with Locking plate (20 Precontoured Clavicle Plate) and 20 Patients who were operated with nailing (titanium elastic nail). Outcome measures Like Blood loss, operative time, wound size, union rate and union time and Complications like infection, Nonunion, implant irritation and shortening Were compared between the two groups. Functional outcome was based on Quick DASH score.Results: The mean blood loss in plating group was 89 ml and nailing Group was 35.5ml (p