Conservative Management and Plate Fixation of Mid-Shaft Clavicular Fractures in Adults: Comparative Study

Document Type : Original Article

Authors

1 Orthopedic, faculty of medicine, zagazig university, zagazig, egypt

2 Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.

3 orthopaedic,faculty of medicine,zagazig university,zagazig,Egypt

Abstract

Introduction
Fracture clavicle used to be treated conservatively. But, risk of mal-union and shoulder dysfunction has raised many concerns regarding this way of treatment. Operative treatment for clavicle fracture gained popularity recently for displaced fracture clavicle. So, in our study we compared between the two methods of treatment.
Patients and methods
We conducted a prospective study for all adult patient presented to our hospital with unstable fracture clavicle from August 2016 to September 2017. Patients were divided in two groups A and B, with exclusion of poly-trauma patients. Group A treated conservatively and group B treated by open reduction and internal fixation with plate and screws on the superior surface of the clavicle. The patients were followed up and assessed by constant shoulder score.
Results
The study included 20 patients in two group 10 patient for each group. The demographic data in both groups showed no significant differences. Follow up was 6.2 and 7.3 months in both groups respectively. Union occurred in 5.8 and 5.3 months in both groups respectively. The difference was insignificant for follow up and union; p value> 0.05. Functional outcome was excellent in 8 and good in 2 in group A, and excellent in 6, good in 4 in group B. This difference was found to be significant, p value ˂ 0.05.
Conclusion
From our study and supported by others we recommend that conservative treatment should be the first choice for most patients and operative fixation to be reserved for selected cases.

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