A Comparative Study of Functional Outcome Between Locking Plating and Titanium Elastic Nailing in Middle Third Clavicle Fractures

Context: Clavicular fracture is a common trauma presentation due to supercial location. Common techniques of xation include an open reduction and internal xation by antero-superior precontoured locking plate or open/closed intramedullary xation with Titanium Elastic Nail. Aims: Aim of this study was to evaluate and compare results of internal xation of displaced middle third clavicle fractures using these two modalities. Settings And Design: Hospital based Prospective Comparative Randomized interventional study Methods And Material: Two groups were made for each modality with 25 cases each. Patients were followed for up to 6 months. Primary outcome measures were Constant and Murley scores, and clinical and radiological union. Secondary outcome measures included complications. Statistical Analysis: Chi square test, and independent t tests were performed to calculate p value and hence the signicance of the results. Results: Mean time of clinical union of plating group was 7.36 weeks v/s 9.68 weeks for the nailing group. Mean time of radiological union was 9.60 weeks in plating group v/s 12.16 weeks for nailing group. Constant scores were 91.24 for plating group while it was 87.36 for nailing group at the end of the 6 month follow up. 76% of patients in plating group had no complications while 64% of patients in nailing group were free of complications. Nailing group had more delayed union, nail migration, skin irritation, and 1 case had peri-implant fracture. Conclusions: Open reduction Internal xation of displaced middle third clavicle fractures with precontoured locking plate led to better fracture union rates, less complications, and better functional outcomes as compared to Closed/open reduction internal xation with titanium elastic nail system.