Background: Mid-shaft clavicular fractures are very common and can be treated operatively or nonoperatively. Traditionally, conservative treatment has been practiced, with malunion occurring commonly as a complication. However, there is still no uniform consensus on to leave mid shaft clavicular fracture or to fix it surgically. Aim: To compare the results of surgical management with established modality of conservative treatment, and comparison among operative group (TEN vs Plate). Material and Methods:The prospective Cohort study, with consenting 110 patients (nonoperative and operative treatment, n = 30, loss to follow up 38 & 12, respectively), with mean age of 36.98±12.23 years, who had mid shaft clavicular fractures, was conducted at Level 1 trauma centre in D.Y. Patil Medical College, Kolhapur, between April 2010 to March 2013. Data was analysed using R software v 3.6.0. Functional outcome, union time and complication rate were assessed using, chi-square and independent t-test. Results: Significantly, higher mean Constant and Murley score (CMS), less union time (P<0.01), and less complications (P=0.014), was noted among operative group. Among surgical group, nail vs. plate method used (n=16 vs. 14), excellent outcome (n=11 vs. 9), and CMS score (90.64 vs. 89.57), respectively. Conclusion: Surgical management could be used in, severely displaced mid-shaft clavicular fractures. Further prospective trials are required to establish it. Level of Evidence: Therapeutic Level III.

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Introduction: Distal tibial fractures are common long bone fractures that occur mainly due to a high velocity trauma. These are difficult to treat because of its subcutaneous location and poor blood supply. Many studies have been published on modalities of treatment of distal tibia fractures. Available options are Intramedullary nails, locking plates and external fixators. The aim of our study was to compare intramedullary interlocking (IMIL) nailing and locking plate (LP) for the treatment of these fractures. Materials and methods: This is a prospective study consisting data of 20 patients with distal tibial fractures operated for IMIL nailing and LP. Patients were followed up for radiological and clinical outcome using The American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: The functional outcome was assessed by AOFAS score. Overall 10 patients obtained an excellent result (50%) and 8 obtained a good result (40%) and 2 obtained fair result (10%). IMIL nailing shows lower rate of delayed wound healing and superficial infection and plating may avoid malunion and knee pain. Discussion: The study suggests superiority of IMIL nailing over LP in terms of less rates of infections, early rate of union, early weight bearing. Whereas LP is better in anatomical and fixed reductions of the fracture and less knee pain. Hence the modality of treatment should be based on the patient's injury pattern, surgeon's expertise and clinical condition.