Outcome of Plate Osteosynthesis in Lateral Third Clavicle Fracture Fixed in Adults

Abstract Purpose: Fractures of the lateral end of the clavicle are relatively uncommon. These fractures are unstable due to the various deforming forces that act on the fragments, as well as the small distal fracture fragment. At most times, the deforming forces are not taken into consideration, and the fracture is not fixed securely. In this study, we assessed a fixation technique using plate osteosynthesis to find out whether it provided a stable fixation with a good functional outcome. Materials and Methods: A total of 32 patients with lateral end clavicle fractures were included in the study. After obtaining informed consent and completing preoperative investigations, open reduction and internal fixation using plate osteosynthesis was performed under the regional (brachial) block. Postoperative X-rays were done on day 1 and every 6 weeks after the operation until the radiological union was achieved. Postoperatively, a universal shoulder immobilizer was given for 2 weeks, followed by active mobilization. Patients were asked to do their daily routine work and avoid lifting heavy weights. The functional outcome was assessed at the end of 6 months with the help of Constant Murley scoring. Results: There were no intraoperative complications in the procedure. The mean Constant score was 92.91 ± 3.80, with a median of 94 calculated at the end of 6 months. There was one case of hardware irritation. After 1 month of operation, the patient was complaining of irritation and pain in the shoulder. The patient was evaluated, and there was no re-fracture; a universal shoulder immobilizer was given and managed conservatively. Conclusion: Plate osteosynthesis may be a good method to fix the fractures of the lateral end of the clavicle, which provides a stable fixation with a good functional outcome. It may well be the answer to the fixation questions of the lateral clavicle fractures, although larger comparative studies between the surgical treatment methods are required to confirm the same.