A comparative study between plating versus titanium elastic nail system in the management of mid-shaft clavicle fractures

Abstract

Introduction: Clavicle fracture is one of most common bony injuries. Despite of high frequency, choice of proper treatment is still a challenge. So a comparative randomized study was planned to compare Plating verses TENS for clavicle fracture management.Materials and Methods: In this study a total of 44 patients with displaced mid-shaft clavicle fractures were enrolled. Patients were randomly distributed in two groups A (plating group) and B (nailing group) with equal number of patients 22 in each group. Outcomes were assessed in terms of union, Visual analog scale for pain and complications Shoulder function was assessed using DASH score and Constant Murley score.Results: In group A 14 (64 %) patients had union in about 9-12 weeks with mean union time 13.6 weeks with 2 (9 %) having non-union, 4 (18%) having delayed union and 2 (9 %) having mal-union. In group B 16 (73 %) patients had radiological union within 9-12 weeks & 6 (27 %) patients had union at 13-15 weeks. In group A the wound infection was reported in 3 (14 %) patients during the early post-operative period which was controlled by intravenous antibiotics, hypertrophic scar was found in 2 (9 %) cases. TENS group (Group A) was better in terms of infection as no such complication was found.Conclusion: In the management of acute displaced midshaft clavicular fractures, TENS is superior to plating. Surgery with TENS results good functional outcome compared with surgical plating treatment.