Comparison between Intra-Medullary Nailing Versus Plating for Displaced Mid-Shaft Clavicle Fracture

Background: Clavicle fracture is common fracture in orthopaedics practice because of its subcutaneous and relatively its anterior position. Clavicle fracture constitutes approximately 40-44% of injury to shoulder. Displaced mid-shaft clavicle fractures are most common. But the optimal fixation strategy is still controversial. With this background, we decided to conduct a study in which we compare the two most common type of fixation strategies (Plate fixation versus Intra-medullary nailing) in displaced mid-shaft clavicle fracture, to evaluate their efficacy & safety. However, both methods have their advantages and disadvantages. Methods: 60 cases were selected on the basis of inclusion criteria & divided into two groups of 30 each. Plate fixation was used in group A and Intra-medullary TENS nailing in group B .The duration of study was one year. The primary outcome measurements included post-operative VAS score, post-operative DASH score, Union time, delayed union, Mal-union, Hospital stay, and any other side effects. Results: Both Plate fixation & Intra-medullary TENS nailing is safe and effective procedure for displaced mid-shaft clavicle fracture. But both have certain limitations. Post-operatively VAS score, DASH score & fracture union was quite similar in both the groups but duration of hospital stay was less in group B. Rare complications were seen in both the groups. Conclusion: We concluded that on comparing to plate fixation, Intra-medullary TENS nailing provide good functional outcome and allow early return to occupational activities, with very less chance of any complications.