Evaluation of results of fracture Clavicle by Reconstruction Plate

Background: Clavicle being most common fracture in human. It is mainly managed conservatively. The results are further improved surgically. Most common surgical treatment is locking compression plating. The aim of the present study is to compare results of reconstruction plating for mid shaft clavicle fractures over locking compression plate. Material & method: The study was conducted on the patients of clavicle fractures coming to Patil hospital Ahmednagar. Total 69 patients were operated with 3.5 millimeter reconstruction plate in this study, during the period of 3 years 2016-2019. Total 63 were male and 6 were females. All fractures were fixed with reconstruction plating and the butterfly fragments were stabilized with k-wires. The functional outcome was measured by the constant and murely score [17] at the end of 3 months from the injury. The fracture union time and associated problems are also compared. Results: Out of 69 patients, 61 patients (88.41%) had excellent results. 5 patient (7.25%) had good result and 8 patients (11.60%) had poor functional out come. 5 patients (7.25%) had complications out of which 1 patient (1.45%) had plate breakage, 2 patients (2.9%) had migration of pin. There was superficial infection in 2 patients (2.9%). The study shows excellent results with simple effective economical reconstruction plates with k-wires. The complications were minimal, mainly in the form of pin migration which was only subcutaneous, removed at the time of implant removal. Conclusion: In these study results of reconstruction plating for mid shaft clavicle fracture was studied. It was found that results were improved, in patient’s oriented outcome, earlier return to the function, reduced non union and mal union and was more effective and economical. For management of mid shaft fracture clavicle. The locking compression plate was not found any superior to reconstruction plate.

A Study on Functional Outcomes after Plating of Middle Third Fractures of Clavicle

BACKGROUND Fracture clavicle is one of the most common conservatively treated fractures. Conservative management showed lesser rates of non-union and satisfactory results for fracture clavicle initially. Recent studies showed that the functional outcome following conservative management was not as optimal as it was thought to be. With changing injury patterns, increased incidence of high velocity trauma and increased functional demands of the modern patients which led to thorough evaluation of the functional outcomes following conservative management of fracture clavicle, the outcome was not optimal. Recent studies showed increased rate of non-union among conservatively managed cases compared to those which were fixed internally. Some found residual deficits among patients treated conservatively. We wanted to study the functional outcome and complications following internal fixation of clavicle fractures by using plating techniques. METHODS This prospective study was done in Department of Orthopaedics, Andhra Medical College, Visakhapatnam. We studied functional outcome of 30 fractures of clavicle which were fixed using plating technique during the period October 2016 - October 2018. Thirty patients (n = 30) were treated with plating technique using precontoured locking plates and recon plates. The fractures in this study were middle third clavicle fractures which were divided into two types based on the classification of Robinson. Type 2 Robinson clavicle fracture implies that it is a middle third clavicular fracture, which is further divided based on fracture morphology. 2b1: Displaced simple or wedge comminuted fractures 2b2: Segmental comminuted fractures. In this study, superior plating was done. The implants used were precontoured LCP and recon plates. Functional outcome was assessed using Constant Murley scoring and Quick Dash score at 10 weeks. The follow up period was for 1 year - October 2016 to October 2018. RESULTS The average time of union for the fractures treated with plating technique in our study was around 10.2 weeks. The mean Constant Murley score of our study was 91. Eighteen out of 30 patients had excellent outcomes. One patient had fair outcome due to stiffness of the shoulder. 10 patients had good result. The average DASH score of the patients was about 9.8. CONCLUSIONS Treatment of fracture middle third of clavicle using plating technique provides good functional outcome and faster recovery with minimal complications. KEYWORDS Clavicle A02.835.232.087.227, Wounds and Injuries C26, Postoperative Complications C23.550.767

Prognosis in Conservative Treated Fracture Clavicle

Introduction: Traditionally most of clavicular fracture can be treated conservally .Operative treatment is usually indicated for open injuries, lateral clavicular fracrure, fragments pressing the plueral cavity, neurovascular compromise, overlying skin. The main aim of this study was to determine the shoulder functional outcomes after clavicle fractures in conservative treated patients. Method: Retrospective study of 261 patients of comservative treated clavicular fracture selected . Patient were examined after 3 months and 6 months according to below given test protocol and constant score was calculated with reference constant.Pain measured as 0-15 within ordinary shoulder activities within 24 hours. Activtites of daily living as 4 questions deal with everyday activities expect over last week (0---20points). Four different active and pain free movement of the arm are performed (0-20). Result: All the patient with fracture clavicle without associated other injuries were treated conservatively for 4-8 weeks, and then constant score of both affected and nonaffected side were calculated and compared of both sides after 3 and 6 months as described in materials and methods. Difference between normal and abnormal side graded as more than 30 pooor, 21-30 fair, 11-20 Good, less than 11 excellent. Conclusion: Conservative treated case of clavicular fracture is easy way to treat the cases in OPD bases but it lead to high rate of shortening and nonunion. In few case Operative should be done to restore the normal functional of shoulder intregreity