Publication:

A comparative study between plating versus titanium elastic nail system in mid-shaft clavicle fracture management

Background Clavicle fracture is one of most common bony injuries. Despite of high frequency, choice of proper treatment is still a challenge. So a comparative randomized study was planned to compare Plating verses TENS for clavicle fractures management.

Methods Study was conducted in Department of Orthopedics, M.K.C.G Medical College, Berhampur from November 2015 to October 2017.Patients aged from 20-55 years with closed displaced were included in study. Patients were randomized in two groups- One group (25 pateints) treated with TENS and second group (25) with plate. Outcome assessed by pain VAS score, Constant & Murley score, DASH score, cosmetic result, radiological fracture healing time.

Results Mean fracture union time in TENS group was 11.4±2.12 weeks and in plate group 13.4±3.46 weeks (difference was significant p=0.016). Mean pain VAS score in TENS group was 2.56±0.91 and in plating group 3.12±0.8 (p=0.023). Tens group were cosmetically more satisfied (mean score 4.48±0.7) than plate group (mean score 3.8±1.0, p=0.009). Mean DASH and Constant Shoulder Score in TENS group were 1.87±3.4, 9.36±7.04 and plate group 4.8±9.0 and 15.08±9.4 respectively. Both were significant (p=0.039, p=0.000).

Conclusions Our study found that patients treated with TENS showed excellent outcome in 84% cases while 60% in plating group for displaces mid-shaft clavicle fracture. Patients in TENS group better in terms of Constant & Murley score and DASH score than treated with plate.