Virtual Conference
Kaustubh Belapurkar

Kaustubh Belapurkar

Government Medical College and Hospital, India

Title: Functional and radiographic outcomes of mid shaft clavicle fractures treated by titanium elastic nailing


Introduction: Fractures of the clavicle is a common injury accounting for about 2.6-5% of all injuries. Mechanism of injury is either a direct blow to anterior shoulder or a fall on the outstretched hand. Clavicle fractures have a bimodal age distribution. The commonest site of clavicle fracture is the mid-shaft-80%. Historically these fractures were treated conservatively using arm sling or a figure of eight bandage. Non-union rate was long assumed to be minimal in these fractures and malunion was assumed to be of no functional significance. Recent studies however have reported a higher rate of non-union. Malunion of midshaft clavicle fracture has also been shown to be associated with distinct patient symptomatology and functional deficits. With numerous treatment modalities available, the optimum treatment modality for this common fracture remains elusive.

Methods: A prospective interventional study was carried out over a period of 18 months. Following inclusion criteria was used- age of more than 18 years, closed midshaft clavicle fractures. Patients with pathological fractures, open fractures, associated neurovascular injuries were excluded from the study. A Titanium Elastic Nail was used for fracture stabilization. Patients were followed up regularly at 2 weeks, 6 weeks and 14 weeks with clinico-radiographic parameters. Functional outcome was measured using DASH score and Constant-Murley score at each follow up visit.

Results: A total of 26 patients met the inclusion criteria for the study. Motor Vehicle accident was the most common mode of injury (62%). AO classification, type 15B1 was found to be most common. (42%). Medial hardware prominence was most common hardware related complication.  Average time for radiological union was 7.5 weeks . Average DASH Score at 14 weeks was 13, average Constant score was 95 suggesting excellent functional outcome.  It was concluded that TENS nail for closed midshaft clavicle fractures ensures high fracture union rates with excellent functional outcomes.


Kaustubh Belapurkar has completed his M.B.B.S from Kasturba Medical College, Manipal-Mahe, India.  He has done his Post Graduation in Orthopaedics from Government Medical College, Nagpur, India. He is currently working as a Senior Resident in GMCH, Nagpur. He is actively involved in Post Graduate teaching program and in Arthroscopy teaching program at the Hospital. He has extensive experience in Trauma surgeries with an interest and Sports medicine and Arthroplasty.