Functional Outcomes of Midshaft Clavicle Fractures Treated With Plate Osteosynthesis: A Prospective Observational Study

Introduction Clavicle fractures are a common orthopedic injury and account for a significant proportion of shoulder girdle trauma, the majority involving the midshaft region. Although conservative treatment has traditionally been preferred, displaced fractures are often associated with complications such as non-union and functional impairment. Plate osteosynthesis has gained popularity because it provides stable fixation and allows early mobilization. This study aimed to evaluate the functional outcomes of patients with displaced midshaft clavicle fractures treated with plate osteosynthesis. Methodology A prospective observational study was conducted over one year in the Department of Orthopaedics, Balrampur Government Teaching Hospital, Lucknow, involving 30 adult patients with completely displaced midshaft clavicle fractures. All patients underwent open reduction and internal fixation with pre-contoured plates. Functional outcomes were assessed using the Constant-Murley shoulder (CMS) score at six weeks, 12 weeks, 18 weeks, and six months postoperatively. Fracture union was evaluated radiographically. Results The mean age was 41.57 years, with men constituting 73% of the cohort. Falls and road traffic accidents were the most common injury mechanisms. Fracture union was achieved in all cases at a mean duration of 12 weeks. The CMS score improved from a mean of 69.97 at six weeks to 88.97 at six months (repeated-measures ANOVA, F(3, 87) = 74.79, p < 0.0001). At six months, 50.00% (n = 15) of patients had an excellent outcome and 43.33% (n = 13) good outcome. Complications occurred in 20.00% (n = 6) of patients (infection 10.00%, delayed union 6.67%, and hardware failure 3.33%); 80.00% had no adverse events. Conclusion In this study, plate osteosynthesis for displaced midshaft clavicle fractures was associated with progressive functional improvement, a high union rate, and an acceptable complication profile. These findings describe outcomes in this cohort and do not establish comparative effectiveness; larger comparative studies with longer follow-up are needed.