Changing trends in the management of adult clavicular fractures. A prospective study

Clavicular fractures account for approximately 2.6 % of all fractures. Fractures occur most commonly in the middle third of the bone .Various treatment methods are:-Non Operative: A multitude of slings, straps and braces have been proposed for clavicular immobilization and treatment of fractures. Operative: External fixators, Intramedullary devices, Plates and screws. The aim of the present study was to analyze the results of fixation of clavicular fractures with plate and screws with regard to assessing the union radiologically, complications associated with the procedure and restoration of range of motion and function of the shoulder and to evaluate the results clinically regarding pain, activities of daily living, range of motion, power, radiologically regarding union, non-union, refracture, screw and plate loosening, implant breakage. A total of 25 cases of midshaft clavicular fractures which were Allman (type I ) closed & fresh were included. They were treated by open reduction & internal fixation with S-shaped clavicular LCP in 17 patients and 3.5mm reconstruction locking plate in 8 patients. The age of patients in this study ranged from 18-50 years. Males formed 68% of the patients. Most common cause of the fracture in this was road traffic accidents (52%). Right side was involved commonly (56%). Duration from injury to surgery was an average of 3.56 days and hospital stay was an average of 4.44 days. The time taken for complete radiological union ranged from 6 to 10 weeks. The time taken to return to previous level of activity ranged from 8 to 20 weeks. Overall excellent results were achieved in 23 patients & good in 2 patients.