A functional outcome of lateral end clavicle fractures treated surgically with open reduction and internal fixation

Prabhav P. Tijoriwala; Kashish Shah; Raj Gadhavi; Prakash Chaudhary

doi:10.18203/issn.2455-4510.IntJResOrthop20263900

Authors

Prabhav P. Tijoriwala Department of Orthopedics, SMIMER Hospital, Surat, Gujarat, India
Kashish Shah Department of Orthopedics, SMIMER Hospital, Surat, Gujarat, India
Raj Gadhavi Department of Orthopedics, SMIMER Hospital, Surat, Gujarat, India
Prakash Chaudhary Department of Orthopedics, SMIMER Hospital, Surat, Gujarat, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263900

Keywords:

Coracoclavicular augmentation, Distal clavicle fracture, Functional outcome, Lateral end clavicle fracture, Locking plate fixation, Neer classification, Open reduction and internal fixation, QuickDASH score, Radiological union, Shoulder function, Surgical management

Abstract

Background: Lateral end clavicle fractures represent a clinically significant subset of clavicular injuries due to their inherent instability and higher risk of non-union, particularly in Neer type II fractures. Surgical management using open reduction and internal fixation (ORIF) has gained increasing acceptance to restore anatomical alignment and optimize functional recovery.

Methods: This prospective observational study was conducted in the department of orthopedics at SMIMER, Surat, from February 2023 to October 2024. Thirty patients aged 18-70 years with lateral end clavicle fractures (Neer type II and III) were included. Patients underwent ORIF using locking plates, hook plates, or locking plate with coracoclavicular augmentation based on fracture configuration. Postoperative follow-up was conducted at 6 weeks, 3 months, and 6 months. Functional outcomes were assessed using the QuickDASH score and visual analogue scale (VAS), along with radiographic evaluation of fracture union.

Results: The majority of patients achieved radiological union within 12 weeks. Significant improvement in pain scores and shoulder function was observed across follow-up intervals. Most patients demonstrated good to excellent functional outcomes at six months, with minimal complications. Early surgical fixation provided stable fixation, facilitated early mobilization, and improved overall shoulder performance.

Conclusions: ORIF for lateral end clavicle fractures provides reliable fracture union and favorable functional outcomes. Surgical stabilization is particularly beneficial in displaced and unstable fractures, enabling early return to daily activities with satisfactory shoulder function.

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