Abstract
Clavicle fracture account for about 44% of all adult fracture around the shoulder, although non-operative care results in high union rates for most, surgery is indicated in particular if displacement and/or shortening greater than 15–20 mm, lack of cortical apposition in young, healthy, active individual to yield the best clinical results in terms of alignment, union and early mobilisation.
We did a retrospective audit to define the guidelines for admission, safer surgical approach and functional outcome using oxford score for the period Jan2002–Jan2007.
This included 35pts, with Female: male ratio 1:2.5, Right: left side of 12:23, just over 50%were manual labours. Most common indication for surgery was displacement/shortening (16pts). 28 pts were operated within 4 weeks as acute admission.
Direct incision was used in 14pts and infraclavicular incision in 21pts.
Radiological union were seen in all pts on average 13.26 weeks (8 – 24wks). 10 patients had minor complications, 28% with direct incision and 19% with infraclavicular approach 29 patients went back to original work by 2.55 month, 5 excluded as 3 were at school, 2 unemployed and 1 did not mention. All patients had an oxford score of 12–20, showing satisfactory joint function.
Metal work were removed in 6 patients, 2 (9.5%) in infraclavicular and 4 (28%) in direct incision.
Conclusion: Our study included 35 patients, union were achieved in all with good functional results. 34 patients express to recommend surgical fixation to others. Infraclavicular approach was associated with less complication and less metal work removal.
Correspondence should be addressed to BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
