Background: Traditionally, clavicle fractures were treated conservatively either by figure of 8 bandage or clavicle brace. This resulted in malunion, nonunion, persistent pain and residual deficit in shoulder strength in many cases. Now–a–days, intramedullary nailing or plating is gaining acceptance. The current study analyses the operative management of midshaft clavicle fractures with titanium elastic nailing and precontoured plating.

Methods: Clinical study of 48 patients aged 25–60 years with fracture of clavicle was carried out. All traumatic displaced midshaft clavicle fractures OTA (Orthopaedic Trauma Association) type B and < 3weeks old were included. Open fractures, pathological fractures and OTA type A/C fractures were excluded. Precontoured plating system (3.5mm) or titanium elastic nails (2.5/3.0mm) were utilized for fixation. Radiological and clinical evaluation using Constant shoulder scoring system was done at regular intervals.

Results: All cases were followed up for an average period of 2.4 years. There was significant difference in both groups (less in nailing group) regarding surgery time (p–0.031), blood loss (p–0.004) and duration of hospital stay (p–0.032). The mean union time was shorter in nailing group (4.1±1.8mo; range 2.5–6mo) than in plating group (7.4± 2.7mo; range 3–11mo). Hypertrophic scar and implant prominence was observed in all cases of plating group.

Conclusion: We concluded that titanium elastic nailing was less invasive, easier to do, and less expensive option with better cosmetic outcomes and early return to work for displaced midshaft clavicle fractures.