Outcomes of non-operative treatment versus plate fixation of displaced midshaft clavicle fractures in adult patients in a Wits teaching hospital
Date
2017
Authors
Tsama, Mluleki
Journal Title
Journal ISSN
Volume Title
Publisher
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.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of
Master of Medicine in the branch of Orthopaedic surgery
Johannesburg, 2017.
Keywords
Non-operative Treatment, Midshaft Clavicle Fractures