Prospective Analysis of Functional Outcome of Clavicle Fractures Treated by Plate Osteosynthesis

Vollständiger Abstract

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Background: Clavicle fractures are common injuries of the shoulder girdle, with displaced fractures potentially resulting in malunion, nonunion, and impaired shoulder function when managed conservatively. Plate osteosynthesis provides stable fixation and facilitates early postoperative mobilization. However, assessment of functional recovery over serial follow-up is important for evaluating treatment outcomes. This study evaluated the functional outcome and fracture healing following plate osteosynthesis for displaced clavicle fractures. Materials and Methods: This prospective observational study was conducted over one year in the Department of Orthopaedics, Balrampur Hospital, Lucknow. Thirty adults with completely displaced clavicle fractures were enrolled and treated with open reduction and internal fixation using precontoured plates. Demographic and clinical characteristics, fracture displacement, operative duration, intraoperative blood loss, fracture union, and postoperative complications were recorded. Functional outcome was assessed using the Constant Shoulder Score at 6 weeks, 12 weeks, 18 weeks, and 6 months postoperatively. Changes in Constant Shoulder Scores over time were evaluated using repeated-measures analysis of variance, followed by Bonferroni-adjusted pairwise comparisons. Results: The mean age of the participants was 41.57 ± 13.58 years, and 22 (73.33%) were male. Midshaft fractures were the most common fracture pattern (66.67%). The mean fracture displacement was 15.23 ± 5.19 mm, operative duration was 88.77 ± 15.02 minutes, and intraoperative blood loss was 179.00 ± 82.51 mL. Fracture union was achieved in all patients at a mean duration of 12.00 ± 2.24 weeks. The mean Constant Shoulder Score improved progressively from 69.97 ± 7.36 at 6 weeks to 78.83 ± 5.66 at 12 weeks, 84.30 ± 4.43 at 18 weeks, and 88.97 ± 5.80 at 6 months. Repeated-measures ANOVA demonstrated a significant effect of follow-up time (F (3,87) =74.79, p