Comparative analysis of plating versus titanium elastic nail system in the treatment of mid-shaft clavicle fractures

Objective: This study aims to compare the efficacy of plating versus the Titanium Elastic Nail System (TENS) in the management of mid-shaft clavicle fractures. Methods: The research was conducted in the Department of Orthopedics, Pt. B.D Sharma PGIMS, Rohtak over two years. The study included patients aged 20 to 55 years with closed, displaced, and isolated fractures of the middle third of the clavicle. During the study period, 122 clavicle fractures requiring surgical intervention were evaluated, with 100 cases meeting the inclusion criteria for analysis. Results: There was no statistically significant difference between the two groups concerning demographic and clinical parameters. The mean age for the TENS group was 34.24±10.5 years, while for the plating group, it was 32.68±12.8 years. Trauma was the leading cause of injury, predominantly affecting males. Road traffic accidents accounted for 56% of cases, while falls from height or sports-related injuries contributed 17%, and falls on an outstretched hand comprised 11%. In both groups, the dominant side was more frequently affected. Based on the OTA classification, 51% of fractures were of the simple (B1) type, while 49% were wedge (B2) fractures. Among the 100 cases, 53 patients were treated with a locking compression plate, 25 with a reconstruction plate, and 22 with a semi-tubular plate. The mean pain VAS score for the TENS group was 2.56±0.91, whereas it was 3.12±0.83 in the plating group, a statistically significant difference. Conclusion: The TENS group demonstrated a significantly higher mean cosmetic score compared to the plating group. Therefore, TENS appears to be a superior approach for managing acute displaced mid-shaft clavicular fractures, yielding better functional outcomes than plating.