Functional outcomes of displaced midshaft clavicle fractures treated with precontoured locking compression plates. A prospective observational study.

Dr. D. Sneha; Dr.Thatipamula Praful Kumar MBBS,DNB

doi:10.51168/sjhrafrica.v6i9.2031

Authors

Dr. D. Sneha Assistant Professor, Department of Orthopaedics, Mediciti Institute of Medical Sciences, Ghanpur(V), Medchal Malkajgiri District, Telangana, India
Dr. Thatipamula Praful Kumar Assistant Professor, Department of Orthopaedics, Mediciti Institute of Medical Sciences, Ghanpur(V), Medchal Malkajgiri District, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2031

Keywords:

Midshaft Clavicle Fracture, Locking Compression Plate, Constant–Murley Score, Functional Outcome, Internal Fixation, Union Rate

Abstract

Background:
Displaced midshaft clavicle fractures are common injuries in active adults. Although conservative treatment has been the traditional approach, surgical fixation using precontoured locking compression plates (LCPs) offers potential benefits of anatomical reduction, stable fixation, and early rehabilitation. This study evaluated functional outcomes, union rates, and complications following open reduction and internal fixation with precontoured LCPs.

Methods:

A prospective observational study was conducted on 30 patients aged >18 years with displaced midshaft clavicle fractures (Allman Group I) treated at a tertiary care center between April 2018 and September 2019. Open fractures, proximal or distal third fractures, pathological fractures, neurovascular injury, and nonunion cases were excluded. All patients underwent open reduction and internal fixation with precontoured LCPs. Functional outcomes were assessed using the Constant–Murley score at a minimum of 6 months follow-up. Radiological union was confirmed by callus formation and the absence of a fracture line. Data were analyzed descriptively.

Results:

The mean age was 37.4 years; males comprised 73.3% of cases (male: female ratio 2.75:1). Road traffic accidents were the predominant cause (70%), and the right clavicle was more frequently involved (60%). The mean union time was 10.33 ± 1.2 weeks, with 90% achieving full shoulder range of motion by 6 months. Constant–Murley scores showed 73.3% excellent, 20.0% good, 3.3% fair, and 3.3% poor outcomes. Good-to-excellent results were achieved in 93.3% of cases. No nonunions or implant failures occurred; minor complications were limited to transient stiffness in 10% of patients.

Conclusion:

Precontoured LCP fixation for displaced midshaft clavicle fractures provides high union rates, excellent functional outcomes, and minimal complications. Early mobilization and rigid fixation contribute to favorable results.

Recommendations:

Precontoured LCP fixation should be considered in active adults with displaced midshaft clavicle fractures to optimize recovery and reduce disability.

Author Biographies

Dr. D. Sneha , Assistant Professor, Department of Orthopaedics, Mediciti Institute of Medical Sciences, Ghanpur(V), Medchal Malkajgiri District, Telangana, India

is an Assistant Professor in the Department of Orthopaedics at Mediciti Institute of Medical Sciences, Ghanpur (V), Medchal–Malkajgiri District, Telangana, India (June 2025–present). She earned her MBBS from Gandhi Medical College, Secunderabad (2008–2013) and completed her internship at the same institution (2013–2014). She obtained her MS in Orthopaedics from Kakatiya Medical College, Warangal (2017–2020).

Her professional experience includes senior residencies at Government Medical College, Mahbubnagar (Aug 2020–May 2021), Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar (Apr 2022–Aug 2022), and Osmania General Hospital, Hyderabad (Mar 2024–May 2025). She completed a fellowship in Spine Surgery at Yashoda Hospitals, Somajiguda, Hyderabad (Feb 2023–Jan 2024).

Her expertise spans musculoskeletal disorders, trauma care, spine surgery, and joint reconstruction. She is actively engaged in research on arthroplasty outcomes, fracture management, and orthopaedic innovations, and is dedicated to evidence-based practice, patient-centered care, and mentoring future orthopaedic surgeons. ORCID ID: https://orcid.org/0009-0004-2166-0670

Dr. Thatipamula Praful Kumar , Assistant Professor, Department of Orthopaedics, Mediciti Institute of Medical Sciences, Ghanpur(V), Medchal Malkajgiri District, Telangana, India

is a highly talented orthopedic surgeon with over 5 years of clinical experience and commitment to medical education. He began his academic career as a senior resident in the Department of Orthopaedics at MNR Medical College, Sangareddy, serving from 2020 to 2021. He was promoted as Assistant Professor in 2021, where he played a key role in training undergraduate and postgraduate students till 2023. Since 2023 to date, he has been working as an assistant professor in Mediciti Medical College, Ghanpur, Medchal, where he continues to mentor future orthopedic surgeons with dedication and insight. Dr.T.Praful Kumar is renowned for his exceptional surgical skills, encompassing complex trauma fixation, joint replacement, arthroscopic procedures & deformity correction, soft tissue repair and reconstructions, all performed with meticulous precision and an evidence-based approach.

He has authored several publications in reputed peer-reviewed journals, with his research Articles Indexed in leading international databases such as Directory of Open Access Journals (DOAJ), reflecting the scientific rigor, credibility, and impact of his scholarly work in advancing the field of orthopaedics. Highly regarded for his clear, methodical teaching style and his ability to instill both confidence and competence in his trainees, Dr.T.Praful Kumar embodies professionalism, integrity, and excellence in every facet of his clinical and academic endeavours. ORCID ID: https://orcid.org/0009-0009-2592-5740

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