Study of Functional and Radiological Outcome of Midshaft Clavicle Fractures Managed Operatively With Plating

  • Swapnil Bhise MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India,
  • Ashok Ohatker MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India
  • Santosh Borka MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India
  • Siddheshwar Thosar MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India
  • Nitin Kanode MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India
  • Sameer Desai MIMER Medical College, Talegaon-Dabhade,Pune, Maharashtra, India
Keywords: Clavicle, Malunion, Non-union, Plating

Abstract

ntroduction: Clavicle is one of the commonly fractured bones. Shortcomings of conservative treatment are non-cosmetic
bump in addition to non-union in few cases. Shortcomings of operative treatment are hypertrophic scar and hardware-related
issues in addition to surgical site infection possibility. Hence, we decided to carry out prospective follow-up study.
Materials and Methods: A prospective follow-up study was done in 57 consecutive patients from February 2016 to January
2017 at MIMER Medical College, Talegaon Dabhade. Patients were operated with precontoured 3.5 mm dynamic compression
plate over superior aspect of clavicle. Patients were followed up at 2, 4, 6, 12, and 24 weeks after operation.
Results: In our study, mean time for radiological union was 39.4 days only with operative treatment. In our study, only there was
only one case of non-union of 51 patients were present (<2%). Overall, satisfaction rate after operative treatment was quite high
in our study. There were hardware problems in 10 cases of 51 patients, that is, about 19.60% of cases. These included screw
loosening (4 cases) and hardware prominence in 6 cases (i.e. 11.76%). Hypertrophic scar in 2 cases (3.92%) and infection in
1 case (1.96%) were seen. Range of motion of shoulder was near normal.
Conclusion: Open reduction and internal fixation of midshaft clavicle fractures give good functional and radiological outcomes
with high patient satisfaction rate without any major complication.

Author Biographies

Swapnil Bhise, MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India,

Associate Professor, Department of Orthopaedics, 

Ashok Ohatker, MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India

Professor, Department of Orthopaedics, 

Santosh Borka, MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India

Professor, Department of Orthopaedics,

Siddheshwar Thosar, MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India

Resident, Department of Orthopaedics, 

Nitin Kanode, MIMER Medical College, Talegaon-Dabhade, Pune, Maharashtra, India

Senoir Resident, Department of Orthopaedics, 

Sameer Desai, MIMER Medical College, Talegaon-Dabhade,Pune, Maharashtra, India

Resident, Department of Orthopaedics, 

References

1. Tamaoki MJ, Lee BK, Itamura JM. Treatment of displaced midshaft clavicle
fractures. J Bone Joint Surg Am 2017;99:1159-65.
2. Paladini P, Pellegrini A, Merolla G, Campi F, Porcellini G. Treatment of
clavicle fractures. Transl Med UniSa 2012;2:47-58.
3. Robinson CM, Brown CM, McQueen MM, Walkefield AE. Estimating
the risk of non-union following non-operative treatment of a clavicular
fracture. J Bone Joint Surg (Am) 2004;86:1359-65.
4. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and
classification. J Bone Joint Surg 1998;80:476-84.
5. Nordqvist A, Petersson CJ, Redlund-Johnell I. Mid-clavicle fractures in
adults: End result study after conservative treatment. J Orthop Trauma
1998;12:572-6.
6. Sahal A, Altamimi SA, McKee MD. Canadian orthopaedic trauma society.
Nonoperative treatment compared with plate fixation of displaced midshaft
clavicular fractures. Surgical technique. J Bone Joint Surg Am 2008;90:1-8.
7. McKee MD, Wild LM, Schemitsch EH. Deficits following nonoperative
treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am
2006;88:35-40.
8. Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle.
J Bone Joint Surg Am 2009;91:447-60.
9. Naveen BM, Joshi GR, Harikrishnan B. Management of mid-shaft
clavicular fractures. Strateg Trauma Limb Reconstr 2017;12:11-8.
10. Rosenberg N, Neumann L, Wallace AW. Functional outcome of surgical
treatment of symptomatic nonunion and malunion of midshaft clavicle
fractures. J Shoulder Elbow Surg 2007;16:510-3.
11. Andrade-Silva FB, Kojima KE, Joeris A, Silva JS, Mat-tar R Jr.
Single, superiorly placed reconstruction plate compared with flexible
intramedullary nailing for midshaft clavicular fractures: A prospective,
randomized controlled trial. J Bone Joint Surg Am 2015;97:620-6.
12. Bostman O, Manninen M, Pihlajamaki H. Complications of plate fixation in
fresh displaced mid clavicular fractures. J Trauma 1997;43:778-83.
13. Collinge C, Devinney S, Herscovici D, DiPasquale T, Sanders R.
Anteriorinferior plate fixation of middle-third fractures and nonunions of
the clavicle. J OrthopTrauma 2006;20:680-6.
14. Mullaji AB, Jupiter JB. Low-contact dynamic compression plating of the
clavicle. Injury 1994;25:41-5
Published
2018-06-12