Clinical Outcome of Conservatively Managed Midshaft Clavicle Fractures in Adults

Abstract

Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature.

The aim of our study was to analyze the short term functional outcome of non-operatively managed displaced mid-shaft clavicle fracture.

Method In this prospective observational study, 46 consecutive patient with displaced midshaft clavicle fractures treated non-operatively in the Orthopedics Department at the Hospital for Bone & Joint Surgery, the associated hospital of the Postgraduate Department of Orthopedics, Government Medical College, Srinagar, from May 2021 to May 2023  were followed up to three months. All the patient after the diagnosis of the injury, received clavicle brace and arm pouch sling as non-operative management. Functional outcome assessment was done using the Constant score.

Result The mean age of the patient in our study was 36.47 +/- 6.42 years. Clavicle fracture predominant involved male gender (84.7% male Vs 15.3% female), right side was involved more commonly than left (71.6% right  Vs 28.4% Left) and the most common mode of injury was Road traffic accident (RTA 60.1%, Fall 30.9% and sports 9%). The mean clavicle shortening was 0.865+/- 0.48cm. The mean constant score at final assessment 86.75/100. We observed significant correlation between clavicle fracture shortening and constant score at 3 months (p < 0.001).

Conclusion Our study revealed that functional outcome of non-operative management of displaced mid shaft clavicle fracture have a significant correlation with the amount of shortening.