Functional outcome of conservative versus surgical management of mid shaft clavicle fractures at tertiary care centre

• Author Details:   
• Sarfraz Iman
• Chinmoy Das
• HM Mohibur Rahman ^*

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Background: Clavicle fractures are common injuries, particularly in young, active individuals, with midshaft fractures accounting for the majority. While many minimally displaced fractures can be treated conservatively, displaced and comminuted fractures pose a higher risk of nonunion and functional impairment. Recent studies highlight improved outcomes with surgical intervention, especially using locking compression plates. This study compares the functional outcomes and complications of conservative management versus surgical fixation in middle-third clavicle fractures.
Aims & Objective: The aim of this study was to assess the functional Outcomes of treating displaced middle 1/3^rd clavicle fractures using Locking compression plate fixation and figure-of-eight clavicle brace.
Materials and Methods: A total of 32 patients, including both male and female individuals with displaced middle-third clavicle fractures (specifically Robinson type 2B1), were enrolled in our prospective Study. Patients were randomly assigned to either a conservative Treatment group or a surgical management group, each consisting of 16 patients. Follow-up evaluations were conducted weekly for the First 2 weeks post-treatment, followed by assessments at 6 weeks, 3 Months, 6 months, and 1 year. Functional outcomes were evaluated using the Constant and Murley scoring system.
Results: Our findings revealed a significant improvement in the Functional outcomes of patients who underwent surgical treatment. By the 12-month mark, 77% of patients in the surgical group Achieved excellent or good outcomes, compared to only 22% in the Conservative group. Complications observed in the surgical group Included 2 cases each of infection and implant failure, while the Conservative group experienced 3 cases of nonunion.
Conclusion: This study underscores that patients treated with locking compression plating through surgical intervention exhibited superior functional outcomes, characterized by early range of motion and reduced shoulder stiffness, leading to a quicker return to work compared to those managed conservatively.

Keywords: Locking compression plate fixation, Figure-of-eight brace, Constant and murley scoring.