Clinical and radiological outcome of three treatment modalities for fracture clavicle: A comparative prospective study

Background: The present treatment trend for fracture clavicle is fast changing from conservative treatment previously and is having a paradigm shift towards open reduction and internal fixation with a plate/intramedullary (IM) fixation. Methods: Ninety patients between 30 and 60 years of age with fr...

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Main Authors: Kamal Kumar, Rajesh Kapila, Raminder Singh, Priti Chaudhary
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Journal of Clinical and Scientific Research
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Online Access:https://journals.lww.com/10.4103/jcsr.jcsr_152_23
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Summary:Background: The present treatment trend for fracture clavicle is fast changing from conservative treatment previously and is having a paradigm shift towards open reduction and internal fixation with a plate/intramedullary (IM) fixation. Methods: Ninety patients between 30 and 60 years of age with fresh closed, displaced midshaft clavicular fracture and fit for surgery were randomised to receive either conservative (non-operative) treatment (n = 30) or primary open reduction and plate fixation or IM fixation (n = 30). Results: The mean age of the patients was 32.5 years. Union at the fracture site in nailing clavicle in <12 weeks was evident in 80% patients (66.6% and 53.3% in plating and conservative method). The complication rate was maximum in the conservative method (63.3%), followed by plating (36.6%) and least in nailing clavicle (29%). The disabilities of the arm, shoulder and hand score at 1 year was the best in nailing (n = 8), followed by plating (n = 12) and then the conservative method (n = 27). The Constant–Murley score at 1 year was also the best in nailing (nailing 94.5 [excellent], plating 92.7 [excellent] and conservative 70 [good]). Conclusions: The titanium elastic nailing system provides stable fixation, faster union and better functional outcomes in patients with fracture of the clavicle.
ISSN:2277-5706
2277-8357