Functional Outcomes of Displaced Midshaft Clavicular Fractures Treated with Precontoured Locked Plates: A Prospective Study.

BACKGROUND

This study assessed the functional outcomes and complications of open reduction and internal fixation (ORIF) using precontoured superior clavicle locking plates for displaced midshaft clavicular fractures.

METHODS

In a prospective two-center study at Al-Thawra Modern General Hospital and Kuwait University Hospital, Sana'a, Yemen, from January 2018 to September 2024, 65 patients (≥18 years) with closed, displaced midshaft clavicular fractures (displacement >2 cm, shortening >2 cm, comminution, or skin tenting) underwent ORIF. Functional outcomes were evaluated six months postoperatively using the University of California, Los Angeles (UCLA) shoulder rating score. Data were analyzed using SPSS version 26.

RESULTS

The mean patient age was 32.09 years (83.1% male, n=54). Road traffic accidents were the primary mechanism of injury (66.2%, n=43). At 6 months, the mean UCLA score was 32.46 ± 2.54, with 98.5% (n=64) achieving good or excellent outcomes (UCLA score ≥27) and 1.5% (n=1) fair/poor. Complications included hardware irritation (1.5%, n=1), hardware failure (3.1%, n=2), and superficial infections (1.5%, n=1). All patients (100%) reported satisfaction with their outcomes. The UCLA scores varied significantly according to injury mechanism, side, and age, with older patients showing lower scores.

CONCLUSION

ORIF with precontoured locked plates yielded promising functional outcomes, high patient satisfaction, and low complication rates. However, the observational design, lack of a control group, and 6-month follow-up limit broader conclusions. Larger controlled studies are needed to validate these findings and guide the optimal management of displaced midshaft clavicular fractures.