The Comparison of Results of Treatment of Midshaft Clavicle Fracture between Operative Treatment with Plate and Non-Operative Treatment

Background:  clavicle fractures are common and usually heal without complications. in this study, we evaluated the outcomes of non-operative versus operative management of displaced fractures.   methods:  in a prospective clinical trial study, sixty-five patients with displaced clavicle mid-shaft fractures were nonrandomly divided in two treatment groups. the first group underwent non-operative treatment with figure of 8 bandage (30 patients), and the other underwent operative treatment with plate fixation (35 patients). figure of 8 bandage and 3.5 millimeter dcp plate with at least six cortical screws were used in non-operative and operative groups respectively. we followed up all patients at weeks 2, 6 and 12, and at month sixth. in addition to clinical examination and x-ray evaluation, we assessed satisfaction, dash and constant shoulder score for each individual. results:  the average durations of union were 19.3 and 24.4 weeks in operative and non-operative groups respectively (p=0.006). satisfaction with operative treatment was 74.3% and with non-operative treatment was 66.7%, showing no significant difference (p=0.500). the non-union rate was 5.7% in the operative group and 13.3% in the non-operative group (p=0.518). a significant difference between the two groups in terms of dash and constant shoulder scores after the six-month follow-up was not found (p=0.352). conclusions:  according to our results, we recommend operative treatment in mid-shaft clavicle fractures only when there is a definitive indication.