A comparative study of plate fixation versus titanium elastic nail in treatment of displaced midshaft clavicle fractures

Abstract

Background: In the last few decades, there has been an increasing trend towards operative treatment for displaced midshaft clavicular fractures. These fractures are managed by plate fixation and titanium elastic nailing system, but the optimal fixation method for these types of fractures remains a topic of debate. The aim of this study is to compare functional outcome of displaced midshaft clavicle fractures treated with locking compression plate and titanium elastic nail system and its associated complications.Material and Method: 40 patients treated with plating and titanium elastic nailing system between October 2019 and March 2021 were analyzed. They were randomized in two groups (20 in plate group and 20 in titanium elastic system group). Clinical and radiological assessments were performed at the 6th week, 3rd and 6th month postoperatively. The functional outcome was assessed by Constant- Murley score. Both surgical techniques were compared in terms of radiological union, clinical functions and complications associated. Result: Earlier union and functional outcome scores were better for the Titanium elastic nail system group than plating group (p < 0.01). The rate of complications was higher in the plate group compared with the Titanium elastic nail system group.Conclusion: In treating displaced midshaft clavicle fractures Titanium elastic nailing system is superior to clavicular plating. Titanium elastic nailing system technique is safe, minimally invasive and has better functional outcome, faster union, fewer complication and cosmetically more acceptable than plating.