Comparative study of non operative management with primary anatomical locking plating of middle third displaced clavicle fractures - randomised clinical trial

Abstract

Background: Current studies have proven increased prevalence of symptomatic non unions and mal union after non operative management of displaced fractures of mid shaft clavicle. We need to compare outcome and complications between non operative management and primary anatomical locking plating of displaced middle third clavicular fractures. Methods: In a prospective clinical trial 110 patients with middle third displaced clavicle fractures were randomized to either treatment with primary anatomical locking plate fixation (63) [group 1] or non operative management with sling (47) [group 2]. Outcome was based on standard clinical follow up, constant shoulder score, Disability of the Arm, Shoulder, and Hand (DASH) score and plain radiographs. 85 patients completed 1year of follow up. Between the groups with relation to demography, mechanism of injury, associated injuries, injury severity score, fracture pattern, there were no difference. Results: In group 1, there was a significant improvement in constant shoulder score and DASH score at all time-points. (p=0.001 and p