Summary

Outcomes after Treatment of Midshaft Clavicle Fractures

Abstract

Background

Management of mid-shaft clavicle fractures is a great controversy and there is growing interest for open reduction and internal fixation (ORIF), even in the absence of absolute indications; claiming it yields better results.

Aim

to compare union rates, functional results, complication rates and patient satisfaction after management of clavicle fractures either operative or non-operative.
Patients and Methods
Between January 2021 and June 2021; an RCT on 30 patients with mid-shaft clavicle fractures was conducted. Fifteen were managed non-operatively and the other 15 patients received ORIF. All patients were followed up for a mean of one year. We included all patients with a mid-shaft clavicle fracture after skeletal maturity. Patients with absolute indications for ORIF, pathological fractures, associated fractures were all excluded from the study. All patients were assessed for complete union using X-rays, clinically for range of motion (ROM) and using functional scores, namely Constant-Murley, DASH and VAS pain scores.

Results

There was a statistically significant difference between both groups regarding union rates and return to work; favoring the ORIF group, (P value 0.005). No statistically significant difference was found regarding the functional scores; quick DASH, Constant and VAS pain scores. Regarding complications, no significant difference was seen between both groups, although minor differences existed.

Conclusion

ORIF offers better union rates and early return of function as compared to non-operative treatment. Although it is associated with skin and wound complications and hardware irritation, this is not significant to make it an inferior treatment option compared to non-operative treatment.