Prospective study of internal fixation of clavicle fractures by various methods

Abstract

Background: Fractures of the clavicle have been traditionally treated non-operatively. Although many methods of closed reduction have been described, it is recognized that reduction is practically impossible to maintain and a certain amount of deformity and disability is expected in adults. More recent data based on detailed classification of fractures, suggest that the incidence of nonunion in displaced comminuted clavicular fractures in adults is between 10 and 15%. All fractures with initial shortening of >2cm resulted in nonunion. According to Rowe a nonunion rate of 0.8-1% is seen in conservatively managed patients Materials and Methods: This is prospective study and was carried out from September 2016 to September 2018 at Orthopedics Department in Maharajah’s Institute of Medical Sciences. During this period 30 patients of clavicle fractures were treated surgically. All the patients were evaluated functionally (constant murley scoring) and radiologically for union with a follow up period of 12monthsResults: Majority of the patients were with middle third clavicle fracture i.e. 26 (87%) patients. road traffic accidents were the most common mode of injury with males 18 (60%) predominant and left side(60%) being the commonest side involved in this study. Majority of the cases were operated less than 10 days. Radiological union observed in 8-12 weeks in 29 (97%) cases, 26 (86%) cases had excellent functional outcome at final follow up.Conclusion: This study concluded that primary open reduction and internal fixation with plate and screws for displaced middle third clavicle fractures provides a more rigid fixation and does not require immobilization for longer periods. It helps in getting back to daily activities and early mobilization.