CONSERVATIVE VS SURGICAL MANAGEMENT OF CLAVICLE FRACTURES: A COMPARATIVE STUDY OF FUNCTIONAL OUTCOMES

Abstract

Background: Clavicle fractures are among the most common orthopaedic injuries, accounting for a significant proportion of shoulder girdle trauma. The majority occur in the midshaft region due to its anatomical and biomechanical vulnerability. Traditionally, conservative management has been the standard approach, offering satisfactory union rates and acceptable functional outcomes. However, recent evidence suggests that surgical intervention may provide superior results in selected cases, particularly in displaced fractures. The optimal management strategy remains controversial, with ongoing debate regarding functional outcomes, complication rates, and patient satisfaction. Materials and Methods: This prospective comparative study was conducted at Government Dindigul Medical College Hospital over a period of two years, from January 2024 to January 2026. A total of 120 patients with clavicle fractures were included after applying inclusion and exclusion criteria. Patients were divided into two groups: conservative management (n=60) and surgical management (n=60). Conservative treatment involved immobilization with an arm sling, while surgical management consisted of open reduction and internal fixation using plate fixation. Functional outcomes were assessed using the Constant-Murley Score and DASH score at regular follow-up intervals of 6 weeks, 3 months, and 6 months. Time to union and complications were also recorded and analyzed statistically. Results: The surgical group demonstrated significantly better functional outcomes, with higher mean Constant-Murley scores and lower DASH scores compared to the conservative group. Time to fracture union was shorter in surgically treated patients. The conservative group showed higher rates of nonunion and malunion, whereas the surgical group had implant-related complications such as infection and hardware irritation. Conclusion: Surgical management of displaced clavicle fractures provides superior functional outcomes and faster recovery compared to conservative treatment. However, conservative management remains effective for minimally displaced fractures. Treatment decisions should be individualized based on fracture characteristics and patient-specific factors. Further large-scale studies are required to validate these findings.