An Indian study on analysis of outcome of middle 1/3rd fracture of clavicle treated by open reduction and internal fixation using locking compression plates: A prospective

Abstract

Clavicle fracture accounts to 4% of all fractures and 44% of fractures of the shoulder girdle. 1, 2, 3 During initial times clavicle fracture was managed conservatively using sling or figure of 8 brace. Traditionally even displaced mid 1/3rd shaft of clavicle fractures were treated conservatively. 4 Furthermore, there is some evidence that conservative management affects the outcome in terms of upper limb function and that treatment of non-unions produces inferior results.5 clavicle fracture was classified based on Allman classification of which group 1-middle 1/3rd clavicle fracture accounts for 80% of all clavicle fractures.6 Recent studies have shown that open reduction with internal fixation with 3.5 mm LCP gives better result when compared to conservative management in displaced mid-shaft clavicle fracture. 7, 8 the main advantage of open reduction and internal fixation is early return to daily activities and decreased in pain when compared to conservative management in displaced middle1/3rd clavicle fractures.9,10 All operated patients were examined for maturation of surgical scar, cosmetic appearance, radiological union and range of movements of shoulder. It was found that 90% of fracture united un- eventfully. In 3% patients delayed union was noted, infected non-union in 3% cases, neurological deficit in 3% cases and 1% patients had implant failure due to screw back out of non-locked screws. This study gives us a message that all middle 1/3rd fracture fixed by LCP provide quite excellent functional and radiological outcome, which is now a days considered as treatment of choice.