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Article . 2025
License: CC BY
Data sources: Datacite
ZENODO
Article . 2025
License: CC BY
Data sources: Datacite
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Functional Outcomes of Displaced Midshaft Clavicular Fractures — A Comparison of Plate Fixation and Non-operative Treatment

Authors: Rahman, Mahmudur; Das, Chandan Kumar; Chowdhury, Mizanur Rahman; Hye, Mohammad Abdul; Uddin, Jamal; Anwar, Khaled Ibney; Rahman, Moshiur; +1 Authors

Functional Outcomes of Displaced Midshaft Clavicular Fractures — A Comparison of Plate Fixation and Non-operative Treatment

Abstract

Introduction: Displaced midshaft clavicular fractures are still disputed regarding the treatment. While conventional nonoperative treatment has been the standard, new research indicates that surgical fixation produces superior outcomes. In this study, the complications and functional outcomes of plate fixation and nonoperative treatment for these fractures are compared. Methods & Materials: This prospective observational study took place from July 2018 to June 2022, involving 200 patients with displaced midshaft clavicular fractures. Group A (n=100) had open reduction and internal fixation using precontoured locking plates. Group B (n=100) received nonoperative treatment with figure-of-eight bandages or slings. Patients were followed for one year. We assessed outcomes using Constant-Murley scores, checked for radiographic union, and recorded complication rates. Cox proportional hazards models, t-tests, and chi-square tests were used for data analysis on SPSS v26. Results: Group A showed significantly lower complication rates compared to Group B (5% vs 20%, p=0.01), shorter mean union time (6.8 vs 9.4 weeks, p<0.0001), and better functional results, with 88% achieving excellent outcomes in Group A compared to 71% in Group B (p=0.001). Surgical patients had a 3% infection rate, with no malunion or delayed union, while nonoperative patients experienced rates of 10% malunion, 5% nonunion, and 5% delayed union. Cox regression identified nonoperative treatment as an independent risk factor for complications (HR=2.80, p=0.008). Conclusion: Surgical fixation of displaced midshaft clavicular fractures leads to better functional results, fewer complications, and quicker union than nonoperative treatment. These findings support the use of surgery for displaced fractures in suitable patients who want the best functional recovery.

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Keywords

Single plate fixation, Triangular sling, Figure of eight bandage

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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