Complications after operation of midshaft clavicle fractures.

Background: There is no clear evidence for the choice of treatment in case of midshaft clavicular fractures. To get a better understanding, this study investigated which variables influence the occurrence of complications, and if complications affect the shoulder function. Methods: A retrospective study is performed in 22 patients treated with intramedullary fixation and 10 patients treated with plate fixation, for a midshaft clavicular fracture. Data collected included age, gender, complications, Robinson fracture type, OTA fracture type, time from injury to surgery, union time, Constant shoulder score and DASH score. Patients where also grouped by fracture type, and by complication or no-complication. Results: No significant differences are found in outcome scores between the intramedullary fixation group and the pate fixation group. In the complication group the median age is significantly higher than in the no-complication group. In the complication group the union time is significantly longer than in the no-complication group. In the Robinson type 2B2 group the Constant shoulder score is significantly lower than in the Robinson type 2B1 group. Conclusion: Complications have a negative effect on the shoulder function. Comminuted fractures are at higher risk of getting complications. Plate fixation seems to give better outcome results for comminuted fractures than intramedullary fixation.