Management of midshaft clavicular fracture with help of locking plates: a prospective study

  • Dr Anil J. Nayak Associate Professor, Department of Orthopedics, GMERS Medical College, Dharpur-Patan, Gujarat, India
  • Dr Mahesh Khandelwal Department of Orthopedics, GMERS Medical College, Vadnagar, Gujarat, India
Keywords: Clavicle, Fracture, Compression plated, Screws


Background and Aim: One of the most common human skeleton fractures is middle shaft clavicular fracture. it had been traditionally treated non operatively. The present study was undertaken to study the part of surgical treatment in fresh displaced or communited clavicular fracture.

Materials & Methods: A total of 25 patients with midshaft clavicular fractures were included in the study. All the patients were planned to be treated with locking compression plates and screws.

Results:Of the total 25 patients; 20 patients had direct injury to the clavicle as the cause of the fracture whereas 5 patients had indirect injury to the clavicle. The functional outcome of the treatment: 85% had excellent outcome, 10% had good functional outcome and 5% had fair outcome.

Conclusion: This study shows rigid fixation with locking compression plate and screws for fresh displaced or comminuted middle third clavicle fracture gives immediate pain relief and prevents the development of shoulder stiffness and non union


Download data is not yet available.


1. Postacchini F, Gumina S, De Santis P, et al. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):452-6.[pubmed]

2. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998 May;80(3):476-84.[pubmed]

3. Singh V: Textbook of Anatomy Upper Limb and Thorax: Elsevier Health Sciences, 2018.

4. van der Meijden OA, Gaskill TR, Millett PJ. Treatment of clavicle fractures: current concepts review. J Shoulder Elbow Surg. 2012 Mar; 21(3):423-9. doi: 10.1016/j.jse.2011.08.053. Epub 2011 Nov 6.[pubmed]

5. Zlowodzki M, Zelle BA, Cole PA, et al. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005 Aug;19(7):504-7.[pubmed]

6. Agarwal T, Bhugra H, Jadhav S, Kumar S, Bhugra A: Operative treatment of mid-shaft clavicle fracture by locking plate. Indian Journal of Orthopaedics Surgery 2017;3:356-9.

7. SHAHUL S: Operative Treatment of Clavicle Midshaft Fractures by Locking Plate. 2012.

8. Gadegone WM, Lokhande V. Screw intramedullary elastic nail fixation in midshaft clavicle fractures: A clinical outcome in 36 patients. Indian journal of orthopaedics 2018;,52:322.

9. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin OrthopRelat Res. 1994 Mar; (300):127-32.[pubmed]

10. Andersen K, Jensen PO, Lauritzen J. Treatment of clavicular fractures. Figure-of-eight bandage versus a simple sling. Acta Orthop Scand. 1987 Feb;58(1):71-4.[pubmed]

11. Neer CS. Nonunion of the clavicle. J Am Med Assoc. 1960 Mar 5;172:1006-11.[pubmed]

12. Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. Clin OrthopRelat Res. 1968 May-Jun;58:29-42.[pubmed]

13. Rickert AB, Hosalkar H, Pandya N and Namdari S. Displaced Clavicle Fractures in Adolescents: Facts, Controversies, and Current Trends. J Am AcadOrthop Surg 2013; 21:1-2.

14. Schiffer G, Faymonville C, Skouras E, et al. Midclavicular fracture: not just a trivial injury: current treatment options. DtschArztebl Int. 2010 Oct;107(41):711-7. doi: 10.3238/arztebl.2010.0711. Epub 2010 Oct 15.[pubmed]

15. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007 Jan;89(1):1-10. DOI:10.2106/JBJS.F.00020.[pubmed]

16. McKee RC, Whelan DB, Schemitsch EH, et al. Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials. J Bone Joint Surg Am. 2012 Apr 18;94 (8):675-84. doi: 10.2106/JBJS.J.01364.[pubmed]

17. Hill JM, McGuire MH, et al. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997 Jul;79(4):537-9.[pubmed]

18. White RR and Anson PS. Adult Clavicle fractures: relationship between mechanism of injury and healing. Orthop Trans 1989;13:514-515.

19. Böstman O, Manninen M, Pihlajamäki H. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma. 1997 Nov;43(5):778-83.[pubmed]

20. Böstman O, Manninen M, Pihlajamäki H. et al. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma. 1997 Nov;43(5):778-83.[pubmed]

21. Mittal A, Ramprakash R, Biju R, Prasad SY and Reddy MGK. Effectiveness of low profile pre countered clavicular plate in mid shaft clavicular fractures in young patients. International Archives of Integrated medicine 2015; 2(5):140-146.

22. Wali PC and Nesari SS. Treatment of displaced mid shaft clavicular fracture with open reduction and internal fixation with plate and screws. J Evid Based Med Health 2017; 4(4):201-23.

23. Dhakad R, Panwar M, Gupta S: Plating versus conservative treatment in mid shaft fractures of clavicle: A comparative study. Journal of clinical orthopaedics and trauma 2016, 7:166-70.[pubmed]
Management of midshaft clavicular fracture with help of locking plates: a prospective study
DOI: 10.17511/ijoso.2019.i02.02
Published: 2019-06-30
How to Cite
J. Nayak, A., & Khandelwal, M. (2019). Management of midshaft clavicular fracture with help of locking plates: a prospective study. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 5(2), 74-79.
Original Article