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

Tsama, Mluleki
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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.
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.
Non-operative Treatment, Midshaft Clavicle Fractures