A prospective study of union rates of midshaft clavicle fractures with plate osteosynthesis

Introduction. Internal fixation is the current treatment approach for displaced clavicle fractures, which ensures firm immobilization and pain relief, thus preventing complications such as non-union, shortening and deformity. Aims. The aim of the study is to investigate the union rates with plate osteosynthesis, in order to be able to compare the clinical results obtained by several treatment modalities, in terms of movements, pain relief, return to normal activities and work. Materials and Methods. This is a prospective study on 30 patients with middle third clavicle fractures treated with plate osteosynthesis between December 2018 and October 2020, at Santiram Medical College and General Hospital, Nandyal. The study included patients older than 18 years. Results. The road accident was the most common cause of this fracture in our study, 70% being males and 63% with a right-sided injury. All patients were operated on within one week of the injury. Robinson Type-2B1 was the most commonly observed in our study and was approximately 53%. Twenty patients (66%) were treated with a Recon plate, nine patients (30%) were treated with an anatomical locking compression plate, one patient (3%) was treated with 1/3 tubular plate. All patients were immobilized in an arm sling, allowing a passive range of movements for 2-3 weeks. The duration of hospitalization was six to seven days, while the duration of the union varied from 8-14 weeks. Evaluation of functional outcome was based on Constant-Murley score, showing excellent results in 20 patients. Conclusions. In displaced midshaft clavicle fractures, open reduction with internal fixation has led to good union rates with excellent functional outcomes.