Fracture Clavicle: Is Surgical Fixation a Better Treatment?

Background: Fractures of clavicle represent approximately 3–12% of all fractures treated by orthopedic surgeons. There hasbeen a debate over the years for the best treatment of midshaft clavicle fractures. Our study is intended to find both conceptualand practical guidance for precision treatment with an expectant favorable functional result.Materials and Methods: Out of 50 patients of clavicle fractures, 25 were treated conservatively and 25 were treated operativelyby locking plate fixation. Outcomes were assessed using the disabilities of the arm, shoulder and hand (DASH) score forfunctional assessment.Results: Functional and anatomical outcomes were found to be better in patients treated operatively with better DASH scorescompared to patients treated with clavicle brace and sling.Conclusion: Surgical fixation of fracture clavicle gives better functional outcomes and shorter time for union with betteranatomical reduction than non-operative treatment. Hence, we recommend surgical fixation with a locking plate is the standardof treatment in these fractures.

Treatment of Distal End Radius Fractures - By Various Modalities

Introduction: Fractures of the distal end radius represent approximately 16% of all fractures treated by orthopedic surgeons.Our study is intended to find both conceptual and practical guidance for precision treatment with an expectant favorable result.Materials and Methods: Atotal of 50 patients of distal end radius fractures were treated with cast immobilization, percutaneouspinning, external fixation, and volar locking plate fixation. Fernandez classification was used. Functional outcomes wereassessed using Demerit Point System of Gartland and Werley (modified). The anatomical evaluation was done by Lindstromcriteria (modified).Results: Functional outcomes depend on patient’s age, fracture anatomy, displacement, reducibility, stability, and articularincongruity of fractures. They are related more to the anatomical reduction than to the method of immobilization. Volar lockingplate is a safe and effective treatment for unstable and metaphyseal comminuted fractures.Conclusion: According to Fernandez classification, Type I fractures were the most common. The volar locking compressionplate fixation gives excellent functional and anatomical results than other modalities of treatment. Hence, we recommend volarlocking plate fixation is the best modality of treatment among others.