Anterior inferior plating versus superior plating for middle 1/3rd clavicle fracture: a prospective comparative study

Background: Fractures of the clavicle are common injuries that may result from direct blow or transmitted forces. Deformities are shortening and depression of lateral fragments. Various techniques are performed out of which superior and anteroinferior plating are widely used with each having its own merits and drawbacks. Our study compares the outcome between above mentioned techniques.Methods: We conducted a prospective comparative study of 60 patients who has met inclusion criteria and out of which 30 patients were treated with anteroinferior technique and 30 patients were treated with superior plating technique. Outcome measure were assessed through constant and murley score.Results: The demographic analysis of our study showed that the incidence of fracture is predominant among males (63.3%) with RTA being the most common mode of injury. AO/OTA classification which was used in our study revealed A1 as the most frequently involved group. Each group had 2 patients with infection post operatively which was managed with appropriate antibiotics. Increased incidence of delayed union was found in anterioinferior group (13.3%) with decreased hardware prominence in comparison with superior plating.Conclusions: There were no significant differences in functional outcome between both the groups except the fact that superior plating had higher chances of plate prominence. So either of the surgical technique can be employed depending upon the feasibility of surgeon

Modified Mclaughlin procedure for neglected posterior dislocation of shoulder: short-term results

Between 2017 to 2020, A prospective case series for assessment of short-term outcomes was carried out on 10 shoulders with 3 being bilateral cases and diagnosed as neglected posterior dislocation of shoulder at a tertiary care centre and treated with the Modified Mclaughlin procedure. All patients had articular defect ranging from 27-46% as confirmed with computerised tomography. All the surgeries were carried out by a single team of surgeons. After 24 weeks follow up of 10 shoulders with mean age 32 years, all patients were found to have excellent results in terms of ROWE and constant score. Patients had significant reduction in VAS score. Timely diagnosis of articular involvement plays a vital role in management for which computed tomography has a pivotal role. Depending upon the articular involvement, line of management is to be decided. So, it can be concluded that, in cases of articular defect >25% following posterior dislocation of shoulder, better outcomes can be achieved with modified Mclaughlin procedure in terms of radiographic union and clinical scoring