Introduction: Fracture clavicle used to be treated conservatively. But, risk of mal-union and shoulder dysfunction has raised many concerns regarding this way of treatment. Operative treatment for clavicle fracture gained popularity recently for displaced fracture clavicle. So, in our study we compared between the two methods of treatment. Patients and methods: We conducted a prospective study for all adult patient presented to our hospital with unstable fracture clavicle from August 2016 to September 2017. Patients were divided in two groups A and B, with exclusion of poly-trauma patients. Group A treated conservatively and group B treated by open reduction and internal fixation with plate and screws on the superior surface of the clavicle. The patients were followed up and assessed by constant shoulder score. Results: The study included 20 patients in two group 10 patient for each group. The demographic data in both groups showed no significant differences. Follow up was 6.2 and 7.3 months in both groups respectively. Union occurred in 5.8 and 5.3 months in both groups respectively. The difference was insignificant for follow up and union; p value> 0.05. Functional outcome was excellent in 8 and good in 2 in group A, and excellent in 6, good in 4 in group B. This difference was found to be significant, p value ˂ 0.05. Conclusion: From our study and supported by others we recommend that conservative treatment should be the first choice for most patients and operative fixation to be reserved for selected cases.

Background: Calcaneal fractures continue to be one of the most complicated injuries of the lower extremity. The aim of the present study was to evaluate the clinical and radiological results of minimal invasive fixation in management of sanders type II, III calcaneal fractures. Patients and methods: This study was carried out in Zagazig University Hospital and Damietta Specialized Hospital. Eighteen cases were included as a comprehensive sample with sander's type II, III closed fracture. Results:The mean age of the studied cases is 45.33 (SD 9.8) years; 83.3% are males, 83.3% are working and 50% are smokers. About 66.7% of the included cases have fracture due to fall from height, 16.7% road traffic accidents and 16.7% direct trauma. Of the studied cases, 66.7% have right side fracture. About 66.7% of the cases have joint depression by Essex classification, 33.3% Sanders classification III, and 66.7% Sanders classification II. Only 33.3% of the cases have positive subtalar arthritis. The mean range of movement is 85.83 (ranged from 70 to 100), and mean AOFOS score is 87.83 (ranged from 77 to 95). The American Orthopaedic Foot & Ankle Society (AOFAS) score shows statistically significant positive correlation with PIFA pre-treatment, PIFA post treatment and negative correlation with HT pre and post treatment. Conclusion: Treatment of calcaneal fractures using a minimally invasive internal fixation method with a thin plate and bone grafting can provide excellent or good clinical outcomes with few soft tissue complications.

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