Background
Fractured clavicle accounts for around 4% of all fractures and up to 44% of fractures of the shoulder girdle. Fractures of the middle third (or midshaft) account for ~80% of all clavicle fractures. When midshaft clavicle fractures are completely displaced or comminuted, in elderly patients or female patients, the risk of nonunion, cosmetic deformity, and poor outcome may be markedly higher; therefore, surgical stabilization of a complex midshaft clavicular fracture with either plate-and-screw fixation or intramedullary device is indicated.
Objectives
We aimed to evaluate the efficacy of open reduction and internal fixation for displaced midshaft clavicle fractures in 15 patients using plates and screws. Patients were followed-up for an average of 16.5 months (10–24 months).
Study design
This was a prospective study in 15 patients treated with fixation by means of plates and screws for fixation of midshaft-displaced fractures of the clavicle.
Patients and methods
This study included 15 patients with acute displaced midshaft fractured clavicle treated surgically with plates and screws at the Zagazig University Hospital and Health Insurance Hospital from June 2008 to August 2010. There were 10 male and five female patients aged between 18 and 52 years, with an average of 34.6 years.
Results
Patients were followed-up for an average of 16.5 months (range, 10–24 months). Fifteen patients were included in this study; of them, 10 were asymptomatic healthy patients according to the Constant–Murley score evaluation (66.6%) and four presented with symptomatic results due to nonunion, tender scar, prominent implant, and superficial infection in one patient each.
Conclusion
Operative fixation of displaced fractures of the clavicular shaft results in improved functional outcome and a lower rate of malunion and nonunion compared with nonoperative treatment at the end of 1.5 years of follow-up. This study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients.