Observational study to compare the outcome of non-operative and operative management of displaced fracture clavicle: A retrospective study
Journal Title: Indian Journal of Orthopaedics Surgery - Year 2018, Vol 4, Issue 1
Abstract
Introduction For centuries fracture of clavicle has been treated conservatively nonunion of clavicle fracture is rare Malunion was considered to be of radiographic importance only The scenario has changed and there has been a shift towards operative treatment on union cosmesis early recovery grounds Both the methods is compared taking into account the union cosmesis early recovery functional outcome and satisfaction of the patientMaterials and Methods Total 70 patients of displaced fracture of clavicle AO B1 amp B2 were divided into two groups that is nonoperative and operative The informed consent was taken The patient were explained about both modalities amp procedure cost outcome and complications of each modality After the decision of the patient he was allotted to Group I conservative amp Group II operative the study was carried out till 35 patients were included in each group The followup of both grouprsquos patients were done at 6 weeks 3 months 6 months using patients subjective evaluation DASH score range of motion radiological assessment and complication if anyObservation and Result Of all 70 patients the age varied between 2066 years with mean age was 345 years In the conservative group 23657 and in operative group 26 742 had dominant side involvement In nonoperative group there were 3875 cases of nonunion 15 428 malunion 5 142 muscle wasting and 4 114 pressure symptoms in upper limb 2 571 stiffness of shoulder 8 2285 pain after union Of 15 cases of malunion only 7 20 5 1428 patients complaint of hardware prominence and irritation Total 4 1142 patients needed implant removal 2 due to infection and 2 due to hardware problem 6 1714 patients complaint of postoperative infraclavicular hypoesthesia The DASH score was superior in Group II over I at 6 weeks and at 3 months Overall in nonoperative patients 22 6285 were satisfied 1714 were not satisfied in operative group 2880 were satisfied while 7 20 were unsatisfied The average followup period was 95 months 618 monthsConclusion Though operative treatment is better in terms of early mobilization union absence of malunion cosmetically well accepted it has its own complication which should also be taken into consideration while choosing between the two modalities Seeing at satisfaction level in patient related to functional outcome the conservative treatment plays a vital role in poor patientsKeywords Clavicle fracture AO B1 amp B2 Displaced fracture Conservative Treatment Nonoperative treatment Operative treatment Clavicular plate
Authors and Affiliations
Rajinder Kumar, Gaurav Jain, Swapnil Sharma, Nitin Bansal
Keywords
Related Articles
- EP ID EP476574
- DOI 10.18231/2395-1362.2018.0004
- Views 99
- Downloads 0
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