Open reduction and plating for displaced mid third clavicle fractures - A prospective study

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Historically, displaced middle third clavicle fractures were managed non-operatively with a figure-of-8 harness.
• Current trends favor surgical intervention for rigid immobilization, pain relief, and prevention of non-union, shortening, and deformity.

Purpose of the Study:

• To prospectively evaluate the functional outcomes of surgically treated displaced mid-third clavicle fractures.
• To assess the efficacy of open reduction and internal fixation with a superiorly placed locking plate.

Main Methods:

• 25 patients with displaced mid-third clavicle fractures underwent open reduction and internal fixation with a superiorly placed locking plate.
• Follow-up occurred at 3, 6, 8, and 12 weeks, with functional outcomes assessed using Disabilities of the Arm, Shoulder, and Hand (DASH) scores and the Simple Shoulder Test (SST).
• Statistical analysis was performed using One-way ANOVA.

Main Results:

• All 26 operated clavicles (including one bilateral case) achieved union, with a mean healing time of 6.8 weeks.
• DASH scores significantly improved by 8 weeks post-surgery in most cases.
• The Simple Shoulder Test (SST) demonstrated significant improvement in all patients by 8 weeks, with 84% returning to work within 6 weeks.

Conclusions:

• Primary plating of displaced mid-third clavicle fractures with a superiorly placed locking plate is an effective treatment.
• This surgical approach mitigates complications associated with non-operative management.
• It facilitates an early return to pre-injury activities for patients.