Management of mid shaft fracture of clavicle by plating versus conservative methods

Background: Direct fall on shoulder is most common mechanism of injury of fracture clavicle other mechanism include direct trauma to clavicle and fall on outstretched hand. The ideal management of the fracture of the mid-shaft of the clavicle remains a topic of debate. This study aimed to assess the better management of fracture mid shaft clavicle. Patients and Methods: This study included 18 patients with mid-shaft clavicular fractures. The patients were subdivided into : group A (9 patients) for conservative treatment and group B (9 patients) for operative treatment by using plate and screw fixation. Post-operative care was done. Every 2 weeks in first month and half then every month tall full union. At 6 weeks post operation anterior posterior x-ray for the clavicle is done and evaluates progress of fracture union. Patients was to remove the sling and start careful full range of motion and start physiotherapy and rehabilitation. Results: The present study showed no significant difference regards age distribution. In the mean age in conservative group (A) was 39.55 and operative group (B) was 36.11. Left side was the majority in both groups with no significant difference between groups. Regard Robinson classification 2B1 & 2B2 were the major classes with no significant difference between studied groups. Although time of union was shorter among operative cases but there was no significant difference. There was no significant difference between groups however surgical group was better and less regard pain. There was no significant difference between groups however surgical group was better regard Return to ADL. Conclusion: Conservative treatment remains the treatment of choice for simple undisplaced mid-shaft clavicle fractures, for displaced and comminuted fractures the surgical intervention gives better outcomes and early functional recovery in young active adults.