Nailed Versus Plated: Unveiling the Best Fix for Broken Collarbones

A BSTRACT Aim: The aim of the study was to assess the clinical and functional outcome of middle third clavicle fractures treated with TENS versus plate osteosynthesis (PO) using the Constant Murley Score and comparing the radiological outcome. Materials and Methods: Current prospective study was carried out at Chettinad Hospital and Research Institute from August 2021 to April 2022. During this period, surgeries were performed on 41 patients, with 21 patients treated through open reduction as well as internal fixation by employing PO, whereas 20 underwent closed or open reduction with titanium elastic nailing (TENS). Follow-up evaluations were performed at 6 weeks, 3 months, and 6 months postsurgery to monitor clinical as well as radiological union. Results: Three participants had postoperative infections in TENS group. Two participants in TENS group experienced implant breakage. Among the study participants who had hardware irritation, four belonged to TENS group and one belonged to PO group. One participant had delayed union and one had malunion, both of which were found in TENS group. Mean time of union was 3.33 for the PO group and 4.55 for TENS group. Conclusion: PO group had minimal postoperative complications, encompassing implant migration, infection, hardware irritation, malunion, and delayed union compared to TENS group. The constant score at the end of 6 months was higher in PO group, as compared to TENS group. Therefore, we conclude that PO is a better surgical method for clavicular fractures compared to titanium elastic nailing.