CLINICAL AND RADIOLOGICAL OUTCOME IN LATERAL END CLAVICLE FRACTURES FOLLOWING CLAVICLE LOCKING PLATE FIXATION

Aim: The lateral end clavicle fractures comprise around 25% of all clavicle fractures. Various deforming forces acting over here render this fracture unstable. There are various treatment options of the lateral end of clavicle ranging from non-operative to operative methods like coracoclavicular screws, k wire fixation, tension band wiring, hook plates, non- locking and locking plates and coracoclavicular augmentation. In this study, we have evaluated the functional and radiological outcomes of the patients in whom a locking plate was used for fixation of the lateral end of clavicle fractures.

Methods: 15 patients with lateral end clavicle fractures underwent open reduction and internal fixation using a 3.5 mm pre-contoured superior locking plate under general anaesthesia or regional block. Regular post operative X-rays were done until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS)on postoperative day 1 and at 2 weeks. The operated limb was supported by a sling for 3 weeks with intermittent passive and active assisted range of motion exercises. The functional outcome was assessed at the end of 1 month,3 months and 6 months postoperatively with the help of QuickDASH scoring system.

Results: All the fractures achieved radiological union at an average duration of 12.1 weeks (range 9.8-13.4). The mean VAS score on post-operative day 1 was found to be 5 which decreased to 1 at two weeks postoperatively. The mean postoperative QuickDASH score was 52.23+/- 1.9 at the end of 1 month,20.4+/- 1.9 at 3 months and then 1.3 +/-1.6 at the end of 6 months. There was one case of implant backout with hardware promince and one case had superficial infection which responded to short course of oral antibiotics and dressings.

Conclusion: The precontoured superior clavicle locking plates may be a good method to fix the fractures of the lateral end clavicle, providing a stable fixation with good radiological and functional outcome, although larger comparative studies between the various surgical treatment methods need to be done to validate this method of treatment.