Functional Outcome of Surgical Management of Mid-diaphyseal Clavicle Fractures Treated by Plate Osteosynthesis

Abstract

Introduction: Clavicle fractures make up 5% to 10% of all fractures. They result from direct high-energy trauma to the bone or falls on the lateral side of the shoulder. In recent years, clavicle fractures have become more common, and their surgical treatment has increased proportionally. Therefore, a proper understanding of anatomy, mechanism of injury, and radiographic interpretation form the basis of a good outcome. Fractures treated with open reduction and internal fixation (ORIF) will have a good functional and radiological outcome. This study is aimed to evaluate the mid-diaphyseal clavicle fractures treated with ORIF. Materials and Methods: In this prospective study, 30 patients who had mid-diaphyseal clavicle fractures according to Allman’s classification underwent ORIF from June 2020 to June 2022. All patients were followed up for 6 months and an assessment of the outcome was done. Results: Out of 30 patients treated, overall excellent to good outcomes were obtained in 26 patients. No statistical significance was noted between age, sex, mode of injury, and different method of fixation on functional outcome. Overall, the meantime of the fracture union was 16 weeks. Five patients developed complications in our study, surgical site infection in one patient, shoulder stiffness for two patients, implant failure for one patient, and hardware irritation in one patient. Conclusion: Anatomical reduction and stable fixation are essential to good fracture union. It helps in early mobilization of the shoulder, preventing stiffness, and is associated with great patient satisfaction. Earlier the fracture union better the functional outcome.

Keywords

• clavicle fractures treated with open reduction and internal fixation
• constant–murley functional scoring
• diaphyseal clavicle fractures
• mid-third clavicle fractures