A comparative study between plating versus titanium elastic nail system in mid-shaft clavicle fracture management

Background: Clavicle fracture is one of most common bony injuries. Despite of high frequency, choice of proper treatment is still a challenge. So a comparative randomized study was planned to compare Plating verses TENS for clavicle fractures management.Methods: Study was conducted in Department of Orthopedics, M.K.C.G Medical College, Berhampur from November 2015 to October 2017.Patients aged from 20-55 years with closed displaced were included in study. Patients were randomized in two groups- One group (25 pateints) treated with TENS and second group (25) with plate. Outcome assessed by pain VAS score, Constant & Murley score, DASH score, cosmetic result, radiological fracture healing time.Results: Mean fracture union time in TENS group was 11.4±2.12 weeks and in plate group 13.4±3.46 weeks (difference was significant p=0.016). Mean pain VAS score in TENS group was 2.56±0.91 and in plating group 3.12±0.8 (p=0.023). Tens group were cosmetically more satisfied (mean score 4.48±0.7) than plate group (mean score 3.8±1.0, p=0.009). Mean DASH and Constant Shoulder Score in TENS group were 1.87±3.4, 9.36±7.04 and plate group 4.8±9.0 and 15.08±9.4 respectively. Both were significant (p=0.039, p=0.000).Conclusions: Our study found that patients treated with TENS showed excellent outcome in 84% cases while 60% in plating group for displaces mid-shaft clavicle fracture. Patients in TENS group better in terms of Constant & Murley score and DASH score than treated with plate