Indian Journal of Orthopaedics Surgery


Outcomes of fractures of lateral end of clavicle using different modalities of management


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Author Details: Apoorva Vijaysinh Dodia, Purvi A. Dodia, Aparna V. Dodia, Pratik Shah

Volume : 3

Issue : 1

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 54

Article End Page : 58


Abstract

Background: A fracture of lateral end of clavicle has been greatly under-rated in respect to pain and disability. The “usual or routine” treatment is perhaps far short of satisfying, relieving therapy.
Aims: Aims of this retrospective study were to study various aspects of patients with fracture of lateral end of clavicle like age, occupation, mode of injuries, type of fracture, etc. Study also aims to evaluate outcome of conservative versus operative treatment of Neer’s type II lateral end clavicle fractures and ultimately to determine which treatment modality is most suitable for such fractures.
Materials and Methods: Depending on fracture pattern, patients admitted for lateral end clavicle fractures, were either treated conservatively or operatively. Various surgical modalities like plate-screw fixation, K-wiring, tension band wires and coraco-clavicular screw fixation were used. Patients were assessed at admission, 3 months and 6 months post admission. Final outcome was judged in terms of union, range of movement, duration for fracture union, neurological status and ability to perform activities of daily life. The constant shoulder score was used to assess overall functional outcome.
Results and Conclusions: Most of the patients were young males having high functional demands who sustained injury due to fall from height or vehicular accident. Although non union was more common in conservative group, functional outcome was acceptable. We conclude that non surgical treatment should be considered as the first line treatment in type I and III and few type II cases. Operative treatment is preferred in type II unstable fractures. Coraco-clavicular fixation turned out to be the most preferred modality of surgical management for such fractures as compared to the plate-screw construct and k-wiring with or without TBW.

Keywords:
Lateral end clavicle fractures, Neer’s classification, Coraco-clavicular fixation, Constant shoulder score, Static tension band principle