Displaced midshaft clavicle fractures: Conservative VS intramedullary nailing

Abstract

Background: Clavicle fractures are most common and seen across all age groups. The traditional conservative treatment has shown higher incidences of fracture malunion, nonunion, and patient dissatisfaction. Aim is to analyze the outcome of clavicle fracture treated with Intramedullary nailing (IMN) with those treated conservatively in terms of rate of fracture union and functional outcome. Materials & Methods: In this prospective, randomized study of 40 cases with clavicle fracture 20 patients were treated conservatively and 20 with IMN and were followed up at 4th, 8th and 12th week and 6th and 12th month. Time for fracture union was measured radiographically and Functional Outcome was assessed using Constant Murley Shoulder score. Patients with pathological fractures, open fractures, comminuted fractures, segmental fractures and fractures associated with neurovascular injury were excluded. Result: The mean time for fracture healing was significantly shorter in IMN group than conservative group with difference statistically highly significant (p<0.005). There was statistically significant difference between two groups with respect to mean duration for radiological union for Naiking group (p<0.0001) and also with respect to functional outcome at 6th (p<0.0025), 9th (p<0.003) and 12th (p<0.002) month follow-up. Conclusion: In this study Intramedullary Nailing of Midshaft Clavicle Fractures resulted in faster fracture union and Good Functional Outcome compared to those treated conservatively.