BackgroundClavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Conservative management usually fails due to the deforming forces. AimOur study evaluates pain relief, functional outcome, and the union rate in unstable lateral end clavicle fracture fixed by two different modalities of operative management, namely clavicular hook plate fixation and distal radius volar plate fixation. Materials and methodA total of 60 patients with the unstable lateral end of clavicle fracture were evaluated in this study at a single tertiary care center between August 2015 and September 2021. Half of the patients (30 patients) were managed by open reduction and internal fixation with clavicular hook plate. The remaining half (30 patients) underwent open reduction and internal fixation by distal radius volar plate supplemented with coracoclavicular fixation. All patients were followed up for a mean duration of 20 months. The functional outcome was assessed at regular intervals by Constant score and Disability of the Arm, Shoulder and the Hand (DASH) score for a period of one year. ResultThere was significant pain relief and improvement in the functional status of patients. The pain relief was significant in the group managed by distal radius volar plate. The decrease in DASH score and increase in Constant score suggests better functional outcomes in these patients. ConclusionOur study highlights the fact that the distal radius volar plate is an excellent alternative to the hook plate in the treatment of unstable lateral third clavicle fractures. The decrease in pain and improved functional outcome stresses the fact that the volar locking plate is the recent most advancement in the fracture fixation of Neer's type ll fractures. The distal radius volar plate is the recent internal fixation technique to manage unstable lateral end clavicle fractures.
The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.
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