Plate Fixation Versus Conservative Treatment for Displaced Midshaft Clavicle in Adults | ||||
| Medicine Updates | ||||
| Articles in Press, Accepted Manuscript, Available Online from 24 August 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/muj.2025.410729.1245 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mohamed Abdelaziz Fayed1; Abdullah Tawfeek Mohammed  2; Mohamed El-Tabey El-Gritly3; Ahmed El Deriny 1
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| 1Lecturer of Orthopedics at Orthopedic Surgery Department, Faculty of Medicine, Port Said University | ||||
| 2orthopedic surgery at Sharm Elsheikh ,Egypt | ||||
| 3Professor of Orthopedic Surgery Department, Faculty of Medicine, Port Said University, Port Said, Egypt. | ||||
| Abstract | ||||
| Introduction: Midshaft fractures of the clavicle are highly prevalent, representing 80% of all clavicle fractures, particularly among young adults. While traditionally managed non-operatively, recent evidence for completely displaced midshaft fractures reveals considerably higher nonunion rates (15-20%). The aim of this study was to evaluate the functional outcomes and union rates of non-operative treatment in comparison to operative plate fixation for these specific fracture patterns. Methods: A randomized controlled trial was carried out from October 2024 to April 2025, involving 26 patients aged 18-60 with isolated, completely displaced middle third clavicular fractures sustained less than two weeks prior. Patients were randomly divided into two groups: 13 for operative plate fixation and 13 for conservative management. Outcomes were assessed using the Quick DASH score at three and six months and radiographic union. Results: The study found a statistically significant difference in time to union (p<0.001), with the operative group achieving full union in 12.7 weeks compared to 20 weeks in the conservative group. Quick DASH scores were statistically superior in the operative group at 3 months (28.2 vs. 37.8, p=0.028), indicating better early functional outcomes. Complication profiles differed, with malunion affecting five patients (71.4%) in the non-operative group, while the operative group mainly experienced hardware-related issues like painful shoulder (50%) and lateral screws loosening (33.3%). Conclusion: This study demonstrates that operative plate fixation provides improved functional outcomes, a lower malunion rate, and a lower nonunion rate for completely displaced midshaft clavicular fractures compared to non-operative treatment. | ||||
| Keywords | ||||
| Clavicle fracture; displaced fracture; functional outcomes; operative management | ||||
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