Evaluation and Management of Distal Clavicle Fracture in a Tertiary Care Hospital LRH, Peshawar

Background: Distal clavicle fractures are common injuries, often resulting from high-impact traumas such as road traffic accidents (RTAs). The management of these fractures varies, with surgical intervention frequently deemed necessary for NEER type 2 fractures due to their instability and potential for nonunion. Objective: This study aimed to evaluate the prevalence and effectiveness of various management strategies for distal clavicle fractures, with a focus on understanding the impact of surgical versus conservative treatments on patient outcomes. Methods: A retrospective analysis was conducted on 70 patients presenting with distal clavicle fractures at a tertiary care center. The fractures were classified according to NEER's classification system, and the chosen management strategies were documented, including plating, K-wires, tension band wiring, and conservative treatment. Data were analyzed using descriptive statistics to determine the frequency and percentage of each management approach and its outcomes. Results: The majority of fractures were managed surgically (70%), with plating being the most common method (58.6%). NEER type 2A fractures were the most prevalent (28.6%), followed by type 1 and 2B (each at 18.6%). Conservative management was applied in 28.6% of cases. Surgical management, particularly plating, resulted in excellent functional outcomes and a lower complication rate compared to conservative treatment and other surgical techniques. K-wire fixation was associated with a 95.6% satisfaction rate, despite a 26% complication rate involving nonunion and hardware migration. Conclusion: Surgical intervention, especially plating, is a highly effective management strategy for distal clavicle fractures, offering better functional outcomes and fewer complications compared to conservative treatment. The study emphasizes the need for a tailored approach to fracture management, prioritizing surgical options for NEER type 2 fractures to ensure optimal recovery.