Functional and Clinical Outcomes of Middle Third Clavicle Fracture Treated with Reconstruction Plate: A Retrospective Cross-Sectional Study

Abstract

Background: Midshaft (middle third) clavicle fractures form the majority of clavicular injuries and are frequently displaced, risking malunion, non-union, and functional deficits when treated non-operatively. Plate fixation offers stable reduction and early mobilization; reconstruction plates remain widely used, especially in resource-limited settings.

Methods: Retrospective cross-sectional study of 24 adults (18–60 years) with displaced midshaft clavicle fractures treated with open reduction and internal fixation using a reconstruction plate (August 2023–July 2024). Outcomes: Visual Analogue Scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) at 6, 12, and 24 weeks; radiological union at 12 and 24 weeks; complications. Statistics: mean±SD, paired t-tests (6↔12, 12↔24, 6↔24 weeks), McNemar test for paired union proportions; p<0.05 significant.

Results: Mean age 36.54±11.45 years; 83.3% male; mean displacement 2.79±0.51 cm. VAS improved from 4.29±0.46 (6w) to 2.88±0.45 (12w) to 1.83±0.38 (24w); all pairwise comparisons p<0.001. DASH improved from 44.04±2.76 to 29.75±3.15 to 15.88±3.15; all pairwise p<0.001. Radiological union: 12 weeks 14/24 (58.3%); 24 weeks 22/24 (91.7%); McNemar χ²=2.25, p=0.134. Complications: infection 5/24 (20.8%), delayed union 3/24 (12.5%), implant failure 1/24 (4.2%).

Conclusion: Reconstruction plate fixation yielded significant pain and functional improvements with high overall union by 24 weeks and acceptable complication rates, supporting its role as a reliable fixation strategy for displaced midshaft clavicle fractures.