Evaluation of treatment and final outcome of clavicular fractures treated with ORIF

Abstract

Introduction: Clavicle fracture is a common traumatic injury around shoulder girdle due to its subcutaneous position. It is caused by either low- energy or high- energy impact. Fracture of the clavicle accounts for approximately 5 to 10% of all fractures and up to 44% of injuries to the shoulder girdle. About 80% of these fractures are in the middle third of the bone and less often in the lateral third (15%) and medial third (8%).
Aim: To study the role of open reduction and internal fixation (ORIF) in clavicular fractures by single Lag Screw Fixation as surgical procedures over middle 1/3 fracture clavicle, clinically evaluate the results, discuss merits and demerits of surgical procedures, and finally draw conclusions of overall study. Materials and Method: Patients of clavicular fractures at middle third region, Type2 B1 and B2 was treated surgically by using Cannulated Lag Screw. Adult male and female patients above 18 years who require surgical intervention for displaced and comminution fracture. Those with Lateral third and medial third fracture were excluded from present procedure. Results: 28 cases of middle third clavicle fracture were fixed by single cannulated Cancellous Lag screw. Postoperatively patients were given only arm sling and from next day they were encouraged swing exercises. The functional outcome is assessed by Constant and Murley score. In this study most patients had excellent functional range in less than 8 weeks. For 8 patients with comminuted fracture, immobilization in Arm sling was preferred more than 8 weeks with gentle mobilization exercises. Clavicle fracture fixed with cannulated screw Lag fixation had fairly excellent functional outcome in term of recovery time and cost effective with fairly least complication. Conclusion: For displaced, comminuted middle third clavicle fracture Cannulated screws fixation and early mobilization gave excellent results. This method of fixation is easier to perform, cost effective, least chance of complications with good functional recovery.