Functional Outcome of Comminuted Clavicle Fracture Treated With LCP: A Prospective Study
Abstract
Background: Fractures of clavicle are very common injuries, which have been traditionally treated non-operatively but has shown increased rate of malunion and nonunion. Operative fixation of clavicle fracture prevents these complications. Hence to validate this we evaluated the outcome of locking compression plate in treatment of comminuted middle third clavicular fractures.
Material & Methods: 25 cases of closed comminuted middle third clavicular fracture between 18 to 60 years were treated surgically with open reduction and internal fixation with locking compression plate and were assessed radiologically for union and functionally by Constant and Muller score.
Results: All 25 patients of comminuted midshaft clavicle fracture with mean age 28.3 years united in mean duration of 13.2 weeks. As per Constant and Muller score, 18 patients (72%) had excellent functional outcome, good in 5 patients (20%), fair in 2 patients (8%) and none of the patients had poor outcome. 3 patients developed hypertrophic skin scar, 2 patients had plate prominence and in 1 patient superficial infection occurred.
Conclusion: Mid third clavicle fractures treated by locking plate achieve reliable bony union and provides a more rigid stable fixation which does not require immobilization for longer periods. It results in earlier return to functional outcome and improved patient and surgeon results, with decreased rates of nonunion and malunion.
Downloads
References
2. Agarwal S, Das A. Clavicular fractures: a retrospective study of 60 cases. Int J Contem Med Res 2016;3(10):3025-6.
3. Naveen Bm, Joshi Gr, Harikrishnan B. Management of mid-shaft clavicular fractures: comparison between non-operative treatment and plate fixation in 60 patients. Strategies Trauma Limb Reconstr. 2017;12(1):11-8.
4. Balachandar S, Mohankumar K, KathirAzhagan S. Outcome of plate and intramedullary fixation of midshaft clavicle fractures: a search for optimal surgical management. Int J Orthop Sci. 2017;3(3):1050–61.
5. Dhakad RKS, Panwar M, Gupta S. Plating versus conservative treatment in mid shaft fractures of clavicle: a comparative study. J Clin Orthop Trauma. 2016;7(suppl 2):166–70.
6. Reddy Yt, Reddy SS, Reddy V, Vadlamani KV, SureshM. Operative treatment of clavicular fractures: a prospective study. J Evolution Med Dental Sci. 2015;24;4(77):13394-410.
7. Holagundi L, Deepak S, Ramchandra, Dayanand. The study on role of surgical management of clavicle fracture in adults. J Dental Med Sci. 2014;13;2:28-31.
8. Bentley TP, Hosseinzadeh S. Clavicle Fractures. In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507892/
9. Kihlström C, Möller M, Lönn K, Wolf O. Clavicle fractures: epidemiology, classification and treatment of 2422 fractures in the Swedish Fracture Register; an observational study. BMC Musculoskelet Disord. 2017;15;18(1):82-6.
10. Narsaria N, Singh AK, Arun GR, Seth RRS. Surgical fixation of displaced midshaft clavicle fractures: elastic intramedullary nailing versus precontoured plating. J Orthop Traumatol. 2014;15(3):165–71.
11. Singh A, Jain G, Sharma S. Comparative study of Non-operative versus Operative treatment for middle 1/3rd clavicle fracture. Int J Orthop Sci. 2014;4:108-14.
12. Pal CP, Shakunt RK, Kumar D, Goyal A, Tyagi AP, Pippal TC. Functional outcome of conservative and surgical management in mid-third clavicle fractures. J Orthop Traumatol Rehabil. 2015;8(1):11-5.
13. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007;89(1):1-10.
14. Constant CR, Murley AHG. A clinical method of functional assessment of the shoulder. Clin Orthop Rel Res. 1987;214:160-4.
15. Bostman O, Manninen M, Pihlajamaki H. Complications of plate fixation in fresh displaced mid clavicular fractures. J Trauma. 1997; 43:778-83.
16. Pearson AM, Tosteson AN, Koval KJ, McKee MD, Cantu RV, Bell JE et al. Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial. J Orthop Trauma. 2010; 24(7):426-33.
17. Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J Shoulder Elbow Surg Am. 2006;15(2):191-4.
The entire contents of the Orthopaedic Journal of Madhya Pradesh Chapter are protected under Indian and International copyrights. Orthopaedic Journal of Madhya Pradesh Chapter allow authors to retain the copyrights of their papers without restrictions, Authors grant the publisher the right of exclusive publication. The Journal then grants to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, perform and display the work publicly and to make and distribute derivative works in any digital medium for any reasonable non-commercial purpose, subject to proper attribution of authorship. The journal also grants the right to make numbers of printed copies for their personal non-commercial use under Creative Commons Attribution-Non-commercial share alike 4.0 International Public License.