Mid Shaft Clavicle Fractures- Plate vs Titanium Elastic Nail System

ABSTRACT

It was believed that “all clavicle fractures heal well” is no longer valid. Recent trend is towards operative management, consists of Pre-contoured plate or Titanium Elas?c Nail System(TENS) applica?on. Plate fixa?on remains the mainstay of treatment but Titanium Elas?c Nail System applica?on has gained a?en?on in recent years. This study highlights the comparison between two most common modali?es available for treatment of mid-sha? clavicle fractures. Objec?vesCompare the func?onal outcome using Neer’s scoring system, radiological outcome and secondary outcomes between two treatment groups. Methods:Pa?ents sa?sfying inclusion criteria were included in our study and randomized into Group A-operated with plate fixa?on and Group B-operated with TENS. Rou?ne postopera?ve protocol and physiotherapy followed. Regular follow up carried out and assessed as per protocol. Results: We had 15 pa?ents in each group by end of our study. There was no significant difference between the two groups in terms of demographics, ?me to surgery, fracture types. Dura?on of hospital stay, mean fracture union ?me were significantly shorter and cosme?cally more sa?sfied in TENS group. Opera?ve ?me, length of incision, periopera?ve blood loss was significantly higher in plate group and length of clavicle be?er restored. Func?onal outcome was excellent with no significant difference between two groups. Conclusion:Both methods return the pa?ents to their pre-injury func?onal levels without significant complica?ons with excellent func?onal outcome. Titanium Elas?c Nail System applica?on has a shorter opera?ve ?me, lesser dura?on of hospital stay, lower infec?on rate and be?er cosme?c outcome sugges?ng this is the preferred method with no comminu?on whereas plate fixa?on is superior in comminuted fractures.