Outcomes of non-operative treatment versus plate fixation of displaced midshaft clavicle fractures in adult patients in a Wits teaching hospital

Abstract

Background The treatment of displaced midshaft clavicle fractures remains a topic of controversy. In the current literature, most authors favour plate fixation in treating these injuries while some still believe in the traditional non-operative approach. Methods 24 adult patients with displaced midshaft clavicle fractures were randomised to either operative treatment with a precontoured plate (13 patients) or non-operative treatment (11 patients) with an arm sling. At three months follow up their DASH scores; Constant Murley shoulder scores and radiographic evidence of union were compared. Results There was a statistically significant difference between the two groups with the surgical group having better results evidenced by low DASH scores (p=0.008) as well as high Constant Murley shoulder scores (p=0.004) and better union rates (p=0.001) compared to the nonoperative group. Conclusion Primary plate fixation of displaced midshaft clavicle fractures should be considered as it gives better functional and radiographic outcomes compared to non-operative treatment in adult patients.