~ 493 ~
International Journal of Orthopaedics Sciences 2017; 3(4): 493-500
ISSN: 2395-1958
IJOS 2017; 3(4): 493-500
© 2017 IJOS
www.orthopaper.com
Received: 08-08-2017
Accepted: 09-09-2017
Dr. Parth Thakor
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Dr. Jainish Patel
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Dr. Dhruven Kosada
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Dr. Sarvang Desai
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Dr. Jagdish Patwa
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Correspondence
Dr. Jainish Patel
Orthopedics Department,
Dhiraj Hospital, SBKS MIRC,
Sumandeep Vidhyapeeth,
Piparia, Vadodara, Gujarat,
India
Study of operated fracture mid shaft clavicle
Dr. Parth Thakor, Dr. Jainish Patel, Dr. Dhruven Kosada, Dr. Sarvang
Desai and Dr. Jagdish Patwa
DOI: https://doi.org/10.22271/ortho.2017.v3.i4g.68
Abstract
Introduction: It is the study of mid shaft clavicle fracture treated with anatomical locking plates. We
wanted to study to study the surgical management and to assess its functional outcome in displaced mid-
shaft clavicular fractures. To study the duration of union, complications and compare the results of
operated cases with other operative study and conservative study.
Materials and Method: The study consist of 100 patients with mid shaft clavicle fracture. We have
treated patient with anatomical locking plates. Clinical outcome and function results were evaluated by
Constant and Murley scoring system.
Result: We have operated total 100 cases with anatomical plate in mid-shaft clavicle fractures. Average
union time was 11.7 week. We have achieved 80% of excellent result.
Conclusion: Anatomical plate for mid-shaft clavicle fracture are as per shape of the bone. Anatomical
reduction is possible and axial alignment and rotational stability is provided. As plates have groove on
inner surface so it preserves the periosteal blood supply which will help in faster healing of the bone.
Rigid fixation with plate and screws for fresh displaced or comminuted middle third clavicle fracture
gives immediate pain relief and prevents the development of shoulder stiffness and non union.
Keywords: Operated fracture, axial alignment, shoulder stiffness
Introduction
Clavicle links the thorax and shoulder girdle and plays important part in movements at
shoulder girdle. Clavicle fracture is a common traumatic injury due to its superficial position.
It is caused by low velocity or high velocity impact clavicle fracture is about 5-10% of all
fractures and 44% of injuries to the shoulder girdle. About 70%to 80% of these fractures are in
the mid-shaft of and less in the lateral third (12% -15%) and medial third (5% -8%).
A weak area in the clavicle is present at the mid clavicular region, which causes for most
fractures occurring in this region. Several muscular and ligamentous forces act on the clavicle,
and familiarity of these various forces is essential to know the displacements of clavicle
fractures and why some of the fracture patterns lead to cause problems if not reduced and
surgically stabilized. Embryologically clavicle develops from 2 ossification centers separately
and then unites so the junction is weakest point. Anatomically it has two curves which make
the bone vulnerable for fracture at its middle. Distribution of ligament attachment as well as
muscular attachment is as such that medial portion is less mobile than lateral which common
to fracture from middle.
“The incidence of mid clavicular fracture is 64 per 100 000 popula tion. Breaks of the shaft
form 70% to 80% of all clavicular fractures; lateral fractures contribute 15% to 30%, and
medial fractures, at 3%, are rare. Open fracture is an absolute rarity, found in only 0.1% to 1%
of cases. The rate of mid clavicular fractures is more than twice as high in men as in women.
The peak incidence occurs in the third decade of life. Mid shaft fractures have traditionally
been treated non-operatively. Surgical treatment of acute mid shaft fractures was not favoured
due to relatively frequent and serious complications. However, the prevalence of non-union or
mal-union in dislocated mid shaft clavicular fractures after conservative treatment is higher
than previously presumed and fixation methods have evolved. Surgical fixation is accepted as
primary treatment for mid shaft clavicular fractures, because results of non-operative treatment
are not better than operative treatment clinically and functionally. Also persistent displacement
of fragments with soft tissue apposition may cause failure of closed reduction.