Functional Outcomes and Complications of Open Reduction and Internal Fixation Using Precontoured Locking Plates for Displaced Midshaft Clavicle Fractures: A Prospective Interventional Study

Introduction: Clavicle fractures are common injuries, with displaced midshaft fractures traditionally managed conservatively. However, recent evidence suggests that operative treatment may offer superior outcomes. Aim: To evaluate the functional outcomes and complications of Open Reduction and Internal Fixation (ORIF) using precontoured locking plates for displaced midshaft clavicle fractures. Materials and Methods: This prospective interventional study was conducted at the Post Graduate Institute of Swasthiyog Pratishthan from April 2021 to January 2023. Thirty five patients with displaced midshaft clavicle fractures underwent ORIF using precontoured locking plates. Demographic variables assessed included age, sex, mechanism of injury, fracture classification, and associated injuries. Functional outcomes were assessed using the Constant-Murley score at six weeks, three months, and six months postoperatively. Statistical analysis included descriptive statistics, paired t-tests for comparing functional scores, and one-way ANOVA with Bonferroni post-hoc analysis for multiple time-point comparisons. A p-value of <0.05 was considered statistically significant. Results: The majority of patients were male (n=29, 82.86%) with a mean age of 38.7 years. All fractures achieved union, with no cases of non-union. The mean Constant-Murley score improved from 73.8±7.2 at six weeks to 89.7±3.9 at six months (p<0.001). At six months, excellent functional recovery was observed in the majority of patients. Complications occurred in three patients, including hardware irritation in one patient (2.86%) and superficial infection in one patient (2.86%). The majority of patients (48.57%) returned to work within 6-8 weeks. Conclusion: ORIF using precontoured locking plates for displaced midshaft clavicle fractures provides excellent functional outcomes with a low complication rate.