Comparison of functional outcomes and complications of conservative management verses surgical fixation with a locking compression plate in the treatment of displaced middle third clavicular fracture

Authors

  • Nilesh S. Sakharkar Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India http://orcid.org/0000-0001-9452-1760
  • Vikas A. Atram Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India
  • Chandan A. Arora Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India
  • Rohit K. Bhurre Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India
  • Akshay J. Atilkar Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India
  • Kuber Sakhare Department of Orthopaedics, GMCH, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20222698

Keywords:

Displaced middle third clavicular fracture, Locking compression plate, Clavicle brace, Constant and Murley score

Abstract

Background: About 3 to 5 percent of all fractures are clavicle fractures, which account for 45 percent of fractures at the shoulder. While fractures of the lateral and medial thirds of the clavicle account for 15% and 5% of all clavicle fractures, respectively, middle third fractures account for 80% of all clavicle fractures.

Methods: patients were divided into two groups at random. Patients selected for conservative treatment with figure of eight Clavicle Brace and arm sling/pouch were treated with the brace immediately and for surgical intervention with locking plating. Constant and Murley's scoring system was used to check for signs of healing and functional improvement

Results: The 40 patients in the current study include 20 with a new fracture of the mid-third clavicle who underwent surgical treatment with clavicular locking compression plate and screws and 20 who underwent conservative treatment with a figure-eight clavicle brace and arm pouch/sling. There was a statistically significant difference in the Constant and Murley score between the surgical group and the conservative group.

Conclusions: According to the present study, patients with a displaced mid-third clavicle fracture may benefit more from surgery than from conservative treatment.

 

References

Robert Bucholez, James D Heckman, Charles Court- Brown, Rockwood Green’s Fractures in Adults Volume 1 6th Edition 2006, pg 1213-16

Wun-Jer Shen M.D. Tsung-Jen Liu M.D, Young-Shung Shen M.D. Po-Cheng Orthopaedic Institute, 100 Po-Ai 2nd Road, Kaohsiung, 813, Taiwan. Plate Fixation Of Fresh Displaced Midshaft Clavicle Fractures, / Bone Joint Surg[Br]2008;90- B.1495-B

S.Terry Canale, James H. Beaty, Campbell’s Operative Orthopedics Volume 3, 1 llh Edition, pg 3371-76.

Stegeman Et Al. Displaced Midshaft Fractures of The Clavicle: NonOperative Treatment Versus Plate Fixation (Sleutel-TRLAL). A Multicentre Randomised Controlled Trial. BMC Musculoskeletal Disorders 2011,12: 196.

N. Modi, A.D. Patel, P. Hallam Norfolk And Norwich University Hospital NHS Foundation Trust,Norwich,UK. Outcome Of 62 Clavicle Fracture Fixations with Locked Compression Plate: Is This the Right Way to Go? doi: 10.1016/j.injury.2011.06.266.

Wg Cdr V Kulshrestha, Primary Plating of Displaced Mid-Shaft Clavicular Fractures. MJAFI2008; 64: 208-11.

Nordqvist A, Petersson C. The incidence of fractures of the Clavicle. ClinOrthop 1994; 300: 127.

Bostman O, Manninen M, Pihlajamaki H. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma.1997;43:778-783.

Cesare Faldini, Matteo Nanni, Danilo Leonetti, Francesco Acri, Claudi Galante, Deianira Luciani , Sandro Giannini. Nonoperative treatment of closed displaced midshaft clavicle fractures, J Orthopaed Traumatol 2010 ;11:229-36

Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. ClinOrthop 1968; 58: 29-42.

Boehme D, Curtis RJ, DeHaan JT, et al. Nonunion of fractures of the midshaft clavicle. J Bone Joint Surg (Am) 1991; 73: 1219-26.

Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle third fractures of the clavicle give poor results. Journal of Bone and Joint Surgery. British Volume. 1997;79(4):537–9.

Nordqvist A, Petersson C. The incidence of fractures of the Clavicle. ClinOrthop 1994; 300: 127.

Robinson’s CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surgery (Br), 1998; 80: 476-484.

Canadian Orthopedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter randomized clinical trial. J Bone Joint Surg Am. Jan 2007; 89(1): 1-10.

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Published

2022-10-27

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Original Research Articles