Functional Outcome of Closed Displaced Clavicle Fracture Managed Operatively with Pre- contoured Anatomical Locking: A Retrospective Chart Review

Shah G*, Gurung G**, Bista R***, Paudel S***, Sah DN****

Abstract


INTRODUCTION: Clavicle fracture is a common fracture occurring in adults and children. Most commonly, this fracture occurs within the middle third of the clavicle and may be associated with some degree of displacement. Traditional treatment modalities practised for nondisplaced fractures have many controversies. For largely displaced fractures, recent evidences favour operative management as it significantly decreases the rate of nonunion and malunion compared to nonoperative management. The present study was
undertaken to study the role of surgical management in closed and displaced clavicle fractures in terms of functional outcome, duration of fracture healing and postoperative complications.


METHOD: This hospital-based retrospective study was done over a one-year period from 12 January 2015 to 11 January 2016 with study sample of 30 adult patients with displaced closed clavicle
ractures managed with locking compression plate and screw under general anaesthesia. Passive range of motion was started from the fifth postoperative day. Data was collected by convenience sampling technique.


RESULT: Patients were operated on within 3 days of hospital admission.The average period of hospital stay was 10 days. The most common mechanism of injury was road traffic accident (RTA) accounting for 88.3% followed by fall on shoulder accounting for 3.3%. The average time of fracture union was 8 to 12 weeks (mean 9.9 weeks). Good radiographic bony union was achieved in all patients. Constant and Murley score was excellent in 21 (mean 70%) and good in 9 (mean 30%) patients. Postoperatively, 3 patients had superficial surgical site skin infection and 5 patients had hypertrophic scar.


CONCLUSION: The use of the pre-contoured locking compression plate and screws in displaced clavicle fracture provides a rigid, secure and reliable fixation with early mobilisation. It also prevents development of shoulder stiffness and nonunion.


KEYWORDS: Clavicle, Fracture, Non-displaced, Pre-contoured plate and screws.

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