KUMJ | VOL. 9 | NO. 4 | ISSUE 36 | OCT-DEC, 2011

Operative Fixation of Displaced Middle Third Clavicle (Edinburg Type 2) Fracture with Superior Reconstruction Plate Osteosynthesis
Dhoju D, Shrestha D, Parajuli NP, Shrestha R, Sharma V

Background

Conservative management of middle third clavicle fracture has been recently

reported with suboptimal outcomes. Despite higher nonunion rates in initial open

reduction and internal fixation, understanding the problem better and taking in

accounts of previous shortcomings, such fractures can be optimally treated by

open reduction and internal fixation with reconstruction plate.

Objective

To study the outcome of middle third clavicle fracture treated with superior

reconstruction plating in terms of function using Constant shoulder score, union

time and rate, complications and patient satisfaction.

Methods

Twenty patients with displaced middle third clavicle fracture (Edinburg type

2) treated with open reduction and internal fixation with reconstruction plate

implanted in superior surface were prospectively followed for at least one year

after surgery.

Results

There were 20 patients, 16 males and 4 females. The mean age of the patients

was 31.5 years with SD 11.5 years (range 15-60 years) and 5 patients (25%) had

associated injuries. All fractures united in 16 weeks or less in near anatomic position

with complication in 2 (5%) patients, one deep infection and one frozen shoulder

which on subsequent management recovered well. There was no nonunion or

implant failure. The average Constant score was 97.45 in one year follow up and the

patients were relatively satisfied with the treatment.The most common indication

(25%) for hardware removal was young age of the patient, hardware prominence

and occasional discomfort

Conclusion

This small series shows that displaced midshaft clavicle fracture can be optimally

treated with operative fixation implanting the reonstruction plate in superior

surface with six cortical purchases on either side and supervised physiotherapy,

although subsequent surgery for implant removal might be necessary.