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BETTER FUNCTIONAL OUTCOMES IN PLATE FIXATION OF MIDSHAFT CLAVICLE FRACTURE IN DR. SOETOMO GENERAL HOSPITAL

Background: Clavicle fracture is one of the common fractures worldwide, which trends moved from conservative to operative treatment. This study evaluates functional outcomes between patients treated with plating and conservative in Dr. Soetomo, Hospital, Surabaya.Methods: We found 531 cases with midshaft clavicle fracture that came to our ER from 1st January 2014 to 31st December 2018. Patients with a head injury, multiple traumas associated with neurovascular injury, history of re-fracture, malunion or nonunion, open fracture, and pathological fracture were excluded in this study. The final data was 161 patients to evaluate. A conservative group total of 84 patients was treated using an arm sling or figure of eight bandages, and an operative group of 77 patients performed ORIF with S-plate. Clinical and functional scores were evaluated retrospectively with a minimum of 6 months after treatment. Shoulder function evaluated using Shoulder Constant Score and Manual Muscle Test.Results: We found that 117 (72.7%) patients were male with a mean age of 35.4 ± 12.33 years old. The right side was dominantly injured. The manual muscle test on the operative group was five, and the conservative group was four. The constant Shoulder group on the operative group was 93.38 ± 7.529, and the conservative group was 86.60 ± 7.560 (P<0.001), and DASH score on the operative group was 10.05±6.98 and the conservative group 23.67±3.49 (P<0.001).Conclusion: In our study, surgery on clavicle midshaft fracture showed significant improvement and satisfaction in patients than conservative treatment. Patients gained better function in the outcome.