ORIF in middle third clavicle fractures: Resumption of occupation and patient satisfaction

Abstract

Introduction: Conservatively treated displaced clavicle fractures have a non-union rate of 15% and unsatisfactory patient-reported outcomes in 1/3rd of the patients. ORIF with pre-contoured plate gives better functional outcome but is associated with wound and hardware-related complications in 9% to 64% of cases.Purpose: To evaluate patient satisfaction in terms of function, activities of daily living and return to occupation following ORIF with plating for fractures of midshaft clavicle.Methodology: Patients underwent ORIF for midshaft clavicle fracture with pre-contoured clavicle plate using the direct superior approach to clavicle, followed by 4 weeks of sling with gentle range of motion exercises. Resumption of daily activities was allowed after 4 weeks as tolerated by the patient. Patients were evaluated using the Oxford Shoulder Score, shoulder and pectoral girdle range of motion and a general questionnaire to determine the satisfaction of patients with the procedure, at 6 months post-surgery.Result: Of the 17 patients that underwent ORIF for midshaft clavicle fracture, 16 patients (94%) had returned to their original occupation with 1 patient requiring assistance in performing overhead tasks. 1 patient was unable to return to occupation due to associated non-union of a tibia fracture. 15 patients (88%) reported that they were satisfied with the outcome of the surgery.Conclusion: Treatment of midshaft clavicle fractures with ORIF gives good functional outcome and is associated with a high patient satisfaction rate in terms of return to their pre-fracture activity levels for daily living and occupation.