Abstract

Background:To compare and study the functional outcome of displaced midshaft clavicle fractures Between surgical fixation using Open reduction with internal fixation (ORIF) plating and Titanium Elastic nailing system (TENS). Methods: A total of 65 patients with displaced midshaft clavicle fractures (aged between 20-65 years) were randomly allocated to ORIF (n=34; Mean age 43.59±15.55 years; 55.9% males) or TENS (n=31; Mean age 43.36±16.08 years; 61.3% males) groups. Preoperative demographic, clinical characteristics and functional status in terms of Disabilities of Shoulder and Hand (DASH) scores were noted. Intraoperative blood loss and transfusion need were noted. Post-operative complications, duration of hospital stay and mobilization time were noted. The patients were followed up at 2 weeks, 3 months and 6 months follow-ups. At each follow-up functional outcome was noted in terms of DASH scores. Final functional status was measured at 6 months. Data was compared using chi-square and student ‘t’-tests. Results: The two groups were matched statistically for preoperative demographic, clinical and functional characteristics. Mean preoperative DASH scores were 78.47±2.85 and 78.16±3.26 respectively in ORIF and TENS groups. No significant difference in intraoperative and postoperative clinical course was seen between the two groups. Time taken for mobilization was 5.97±1.51 and 5.90±1.25 days respectively in ORIF and TENS groups whereas mean duration of hospital stay was 12.15±1.42 and 11.87±1.98 days respectively in the corresponding group. At six months DASH scores were 24.32±7.27 and 25.00±8.15 respectively in ORIF and TENS groups. An improvement of 69% and 68% in mean DASH scores was seen in the two study groups showing the difference not to be significant. Conclusion:  Both ORIF as well as TENS have comparable clinical and functional outcome in management of displaced midshaft clavicle fractures. Trial registration:Clinical Trials Registry-India (ICMR-NIMS) - CTRI/2022/12/048509
URL of the trial registry: http://www.ctri.nic.in.