MANAGEMENT OF MID SHAFT FRACTURE OF CLAVICLE BY PLATING VERSUS CONSERVATIVE METHODS

Abstract

Background: Direct fall on shoulder is most common mechanism of injury of fracture clavicle other
mechanism include direct trauma to clavicle and fall on outstretched hand. The ideal management of
the fracture of the mid-shaft of the clavicle remains a topic of debate. This study aimed to assess the
better management of fracture mid shaft clavicle. Patients and Methods: This study included 18
patients with mid-shaft clavicular fractures. The patients were subdivided into : group A (9 patients) for
conservative treatment and group B (9 patients) for operative treatment by using plate and screw
fixation. Post-operative care was done. Every 2 weeks in first month and half then every month tall full
union. At 6 weeks post operation anterior posterior x-ray for the clavicle is done and evaluates progress
of fracture union. Patients was to remove the sling and start careful full range of motion and start
physiotherapy and rehabilitation. Results: The present study showed no significant difference regards
age distribution. In the mean age in conservative group (A) was 39.55 and operative group (B) was
36.11. Left side was the majority in both groups with no significant difference between groups. Regard
Robinson classification 2B1 & 2B2 were the major classes with no significant difference between
studied groups. Although time of union was shorter among operative cases but there was no significant
difference. There was no significant difference between groups however surgical group was better and
less regard pain. There was no significant difference between groups however surgical group was better
regard Return to ADL. Conclusion: Conservative treatment remains the treatment of choice for simple
undisplaced mid-shaft clavicle fractures, for displaced and comminuted fractures the surgical
intervention gives better outcomes and early functional recovery in young active adults.