Evaluation of Treatment for Clavicle fracture: Comparision between Conservative Versus Operative Treatment

Song, Kyung Jin; Chang, Ki Young; Hwang, Byung Yun

Abstract

There is still controversies in the treatment of clavicle fracture between conservative versus operative treatment. We reviewed one hundred thirth-six patients(141 cases) treated conservatively and operatively since February 1981 to September 1993 at Chonbuk National University Hospital. The mean follow-up was forth-six months ranging from six months to twelve years. Fifty cases treated surgically and ninty-one cases treated conservatively. In the surgical treatment group, mostly treated with intramedullary nailling with K-wires or Steinmann pin and plating with screws, with or without bone graft. We tried to evaluate the result of treatment between these two treatment groups in the viewpoint of criteria of pain, deformity, limitation of motion, subjective symptoms and disturbance of daily activities and also in the viewpoint of complications like nonunion, malunion, motion limitaion, infection and metal failures. The most common complication of the conservative treatment was malunion and nonunion was the most common complication in the operative treatment. Satisfactory results obtained in 89% of operative treatment group in the functional group and 88% of operative treatment group in the functional evaluation scale. Each clavicle fracture should be treated according to their degree of comminution, site of fracture, neurovascular injury, associated injury and doctors experience as which cases can promptly be treated either conservatively or operatively. But we would like insist of surgical treatment for the cases necessitating surgery for the provention of nonunion, malunion and joint stiffness what are common complications in the conservative treatment of clavicle fractures.