Author : Suraj Shetty, Mayur Rai, Shabir Kassim, Rishabh M Hegde, Shetty Gaurav Kishore
Abstract : Background: Clavicle Fracture is one of the most common bony injuries. Midshaft fractures have
traditionally been treated conservatively. The prevalence of non-union or mal-union in displaced midshaft
clavicle fractures after conservative treatment is higher as compared to those treated with ORIF. Surgery
is believed to be the primary treatment for displaced midshaft clavicular fractures. Operative fixation of
the clavicle fractures results in improved function, shorter time for union, and early return to activity as
compared to those treated conservatively.
Materials and Methods: A hospital-based retrospective and prospective study was conducted at the
Department of Orthopaedics, A.J. Institute of Medical Sciences and Research Centre, Mangalore, for two
years. A total of 100 cases of midshaft clavicle fractures, meeting the inclusion and exclusion criteria
were treated by operative and non-operative methods after ethical clearance. After 3 weeks, physiotherapy
was started. Patient follow-ups were done at 6, 12 and 24 weeks and evaluated radiologically by a senior
orthopaedic surgeon and radiologist.
Results: Males outnumbered females by 66% (i.e 83% against 17%). 54 patients (54%) had an RTA while
the remaining 46 patients(46%) a history of fall. The youngest patient was 19yrs, and the oldest was 72yrs
old. The mean age was 36.93 years. Amongst complications plate breakage in 1 patient, non-union in 13
patients and restriction of range of motion in 18 patients were seen. In our study, 63% of patients had leftsided
fracture while the remaining 37% of patients had a right-sided fracture. Radiological union at 12 and
24 weeks was faster in the operative group (p > 0.05) than conservative group.
Conclusion: Midshaft clavicular fractures treated operatively have better union rates radiologically and
clinically when compared to those treated conservatively.
Keywords: Clavicle fracture, Operative, Non-operative, Radiological Union, Clavicle brace.