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. 2014 Sep;5(3):123-8.
doi: 10.1016/j.jcot.2014.07.012. Epub 2014 Aug 23.

Comparison of treatment of fracture midshaft clavicle in adults by external fixator with conservative treatment

Ajay Shukla  1 , Skand Sinha  1 , Gopal Yadav  1 , Sandeep Beniwal  1
Affiliations

Comparison of treatment of fracture midshaft clavicle in adults by external fixator with conservative treatment

Ajay Shukla et al. J Clin Orthop Trauma. 2014 Sep.

Abstract

Purpose: High rate of malunion and non union in displaced fracture clavicle treated conservatively lead to use of different types of internal fixation methods which also were found to be associated with various complications. Moreover their superiority over conservative treatment has not been established. This study was designed to compare clinical outcome of conservative treatment with external fixator in cases with displaced midshaft clavicle fractures.

Methods: Fifty adult consenting cases of acute midshaft fracture clavicle, displaced >15 mm were included. Twenty five cases were allotted to conservative (group A) and external fixator (group B) each. In group A treatment was given in form of clavicle brace. In group B schanz pins were inserted obliquely between supero-inferior and anterior-posterior direction and connected with rod. The outcome was measured by Constant score, union time and complications.

Results: Mean radiographic union time in group A was 23.45 ± 1.40 weeks (with 8% non union and 80% malunion) and in group B it was 9.36 ± 1.49 weeks. Mean Constant score at 6 months in group A was 78.28 ± 6.45 and in group B 92.72 ± 1.48. Mean shortening at 6 months in group A was 19.36 mm. In group B shortening at 6 months was noticed in three cases (6, 5, 6 mm).

Conclusion: Close reduction of acute fracture mid clavicle and application of external fixator is a simple procedure providing the benefits of rigid fixation and undisturbed fracture environment. Pain relief is faster, union time is shorter and there are no hardware related problems.

Keywords: Clavicle conservative; Comparison fracture; External fixator.

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Figures

Fig. 1
Fig. 1
Shows displaced fracture midshaft clavicle.
Fig. 2
Fig. 2
Shows external fixator on right clavicle after close reduction.
Fig. 3
Fig. 3
Shows union without shortening of fracture clavicle with external fixator.
Fig. 4
Fig. 4
Shows malunion with shortening of fracture clavicle.
See this image and copyright information in PMC

References

    1. Postacchini F., Gumina S., De Santis P., Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002 Sep–Oct;11(5):452–456. - PubMed
    1. Zlowodzki M., Zelle B.A., Cole P.A., Jeray K., McKee M.D. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005;19:504–507. - PubMed
    1. Hill J.M., McGuire M.H., Crosby L.A. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997;79:537–539. - PubMed
    1. McKee M.D., Pedersen E.M., Jones C. Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am. 2006;88:35–40. - PubMed
    1. Nordqvist A., Redlund-Johnell I., von S.A., Petersson C.J. Shortening of clavicle after fracture. Incidence and clinical significance, a 5-year follow-up of 85 patients. Acta Orthop Scand. 1997;68:349–351. - PubMed

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