Sajeer Mushrak, M K (2015) A comparative study of analysis of functional outcome between locking plating and conservative management of middle third clavicle fractures. Masters thesis, Kilpauk Medical College, Chennai.
|
Text
220200415sajeer.pdf Download (2MB) | Preview |
Abstract
INTRODUCTION: Clavicle fractures are of the common injuries accounting for 2.6% to 4% of all fractures with an overall incidence of 36.5 to 64 per 1,00,00 people per year. The most common site of fracture in the clavicle occurs at the middle third and which accounts for almost 80% of all clavicle fractures. Historically conservative treatment has remained the main forte of clavicle fractures for orthopaedic surgeons. Locking plating is the latest implant used in the treatment of clavicle fractures. Recent studies have highlighted a non union rate of 15% with 32% of patient dissatisfaction. AIM OF THE STUDY: To compare and analyze the functional outcome between locking plating and conservative management of middle third clavicle fractures. MATERIALS AND METHODS: This comparative study is conducted in Govt. Kilpauk Medical College from October 2012 to July 2014. About 46 patients with middle third clavicle fractures were randomly classified into two groups Surgical group and Conservative group treated with anatomical precontoured locking compression plate and figure of eight bandage respectively. After radiological evaluation, fractures were classified using Robinson classification and the cases belonging to Robinson type 2B fractures were included in the study. 23 patients in surgical group and 23 patients in conservative group were treated. Out of this, 3 patients from each group missed the follow up and so we included 20 patients in each group for this study. Average follow up for surgical group was 11.65 months and conservative group was 11.85 months. We analyzed the functional outcome using Constant – Murley shoulder score and DASH questionnaire. RESULTS: After proper analysis and statistical comparison we obtained a p-value of 0.005 in Constant score and < 0.001 in DASH score which is considered significant (significance of p-value determined as < 0.05). Individual parameters obtained in the study showed a better functional outcome in surgical group in both constant and DASH scores. Complications included 5 malunions and 2 nonunions in conservatively treated group where as, all fractures went for union in surgical group. Superficial infection in two cases and numbness in the surgical area in one case was noted in surgical group. Infection resolved in one week of intravenous antibiotics and numbness resolved 11 weeks post operatively. CONCLUSION: Our study showed improved DASH score, better constant score, early return to work and decreased nonunion and malunion in surgically treated Robinson type 2B midshaft clavicle fractures compared to conservatively treated group. Hence, we conclude that surgical fixation using anatomical pre contoured locking compression plate in midshaft clavicle fractures (Robinson type 2B) in active adults gives better functional outcome, early return to work, decreased nonunion and malunion and saves man-hour.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Middle third clavicle fractures ; Anatomical pre contoured locking compression Plate ; Robinson classification ; DASH score ; Constant- Murley score. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Sep 2017 03:19 |
| Last Modified: | 25 Sep 2017 16:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3321 |
Actions (login required)
 |
View Item |
