Functional Outcome of Operative fixation of Displaced Mid-Shaft Clavicle Fractures: A Prospective study.

Rajesh, G (2006) Functional Outcome of Operative fixation of Displaced Mid-Shaft Clavicle Fractures: A Prospective study. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: A fracture of the clavicle has been greatly underrated in respect to pain and disability. The “usual or routine treatment” is perhaps far short of satisfying relieving therapy – Carter R. Rowe, 1968. Fracture of the clavicle is common, accounting for 5 to 12% of all fractures. About 70 to 80% of these fractures are in the middle third of the bone. Displaced midshaft clavicle fractures are common and are generally treated non-operatively. Non-operative treatment of these fractures with axial shortening is associated with a non union rate of 13 – 18% and a delayed union rate of 25%. Intractable pain, neurological complications and loss of shoulder function have been reported. So persons with high activity level will hesitate to accept prolonged recovery and impaired shoulder function, therefore may require more aggressive acute treatment of middle third clavicle fractures. Prompt fixation of these clavicle fractures permits increased patient comfort, and early shoulder mobility. In cases of associated scapula fractures, fixation of the clavicle may provide restoration of shoulder mechanics leading to improvement of function. AIM OF THE STUDY: The aim of the study is to “Prospectively analyse internally fixed displaced mid shaft clavicle fractures” in terms of union, complications and functional out come. RESULTS: This study shows excellent results of operative treatment of displaced mid shaft clavicle fractures in adults. The patients treated with early, rigid fixation of their clavicle fractures shared a high postoperative constant score, early pain resolution early return to activity and high patient satisfaction rating. Displaced mid-shaft clavicle fractures are considered as benign injuries with satisfactory outcome if treated conservatively. However several reports challenge this view and there has been a resurgence of interest in operative treatment for fractures of the clavicle that display significant shortening. Possible complications resulting from conservatively treated clavicle fractures are cosmetically displeasing end results, delayed union, persisting non union, chronic shoulder pain and impaired shoulder function. CONCLUSION: The acute treatment of displaced mid-shaft clavicle fractures remains a subject of controversy. Our study demonstrate early pain relief with good shoulder function, quick return to activities and a high patient satisfaction rate. Therefore, we believe that open reduction and rigid internal fixation is a valuable option in the acute treatment of displaced midshaft clavicle fractures in active adults despite a significant risk for complications which is typically well accepted by those patients with high functional demands.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Functional Outcome ; Operative fixation Displaced Mid-Shaft Clavicle Fractures ; prospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 17:30
Last Modified: 17 Sep 2017 13:42

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