Keywords : Middle third clavicular fractures
Comparative study of reconstruction plates versus non-reconstruction plates (dynamic compression plate and locking compression plate) with respect to complications and functional outcome in operative management of middle third clavicular fractures
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 2143-2152
Introduction: Clavicle fracture is a common traumatic injury and account for approximately 2.6% of all fractures. The middle-third fractures (80-85%) are most common of all clavicular fractures and were conservatively treated. Several recent multicenter, randomized control studies reported that open reduction and internal fixation (ORIF) had much lower nonunion and malunion rates as well as better shoulder function compared with non-operative treatment there are few precise data on the complications and functional outcome rates of each plate based on different fracture classifications. The current study aims to understand the complications and functional outcome with various plates.
Material and Methods: A prospective study was done in 40 patients with mid clavicular fractures type B according to Robinsons classification selected by purposive sampling method, during December 2018 to May 2021 in a tertiary care teaching hospital. After obtaining institutional ethical clearance and informed consent, history was collected, findings on general, systemic and local examination were recorded. Clavicular fixation was done under general anaesthesia using plates (reconstruction plate/dynamic compression plate/locking compression plate) and cortical screws. Follow up done to note complications and functional outcomes with different plates and analyzed statistically by chi-square test with P<0.05 as significance level.
Results: Majority of the patients were in the age group of 19-29 years (20 patients/50%) with mean patient age was 32 years. Majorities were males (32 patients/80%). In 20 patients (50%) reconstruction plates were used. In 10 patients (25%) locking compression plates were used.
In 10 patients (25%) Dynamic compression plates were used. The functional outcome was assessed by Constant and Murley score, 29 patients (67.5%) had excellent functional outcome, good functional outcome in 5 patients (12.5%), fair functional outcome in 6 (15%) patients and poor in 2 patients (5%).
Conclusions: Functional outcome was either excellent or good (80%) and complications (45%) were less common in patients managed with non-reconstruction plate compared to reconstruction plate, which was statistically significant.