Functional Outcome of Unstable fracture of Lateral end of Clavicle treated with Tension Band Wiring and Pre-contoured Lateral end clavicle Locking Plate- A Prospective Randomized Controlled Study

Introduction: Fractures of the lateral end of clavicle went largely undiagnosed in the ancient age, so they have a few mentions in the ancient writings. Historically much has been written about fractures of the mid shaft clavicle as they are easily spotted and more common, unlike fractures of lateral third clavicle. Unstable fractures of lateral end of clavicle require operative treatment due to the high rate of observed non-union and even higher rate of delayed union. Materials: we carried out a prospective randomized control study with 30 patients with unstable fractures of lateral end of clavicle treated by open reduction and internal fixation with Tension Band wiring(TBW) and Pre-contoured locking lateral clavicle plate at Gauhati Medical College and Hospital, Guwahati, Assam, India from 1st April 2021 to 30th March 2022. The patients were evaluated for their functional outcome at the end of 6th month of post-operative follow up using Constant-Murley Scoring System. Results: 30 patients between the age group of 20-60 years with unstable lateral third clavicle fractures were randomly allocated into two groups of treatment as per randomization chart. The maximum number of cases was observed in the age group of 31-40 years. At the end of 6th month of post operative period, “Excellent” score was achieved in 13(86.66%) case and “good” results were obtained in 2(13.33%) in pre-contoured lateral end clavicle plate group. While in Tension Band Wiring group, “excellent” score was achieved in 6(40%) cases and “good” results were obtained in 9(60%). Conclusion: Pre-contoured lateral clavicle plate fixation provides better functional outcome than Tension Band Wiring. TBW has more complications than the lateral clavicle plate