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Fracture clavicles are known since ancient time, earliest description of fracture clavicle is found in Egyptian literature in 3550 BC. The clavicle is the only long bone in the body that lies horizontally. Medially, it articulates with the sternum at the sterno-clavicular joint. At its lateral end it articulates with the acromion, at the acromioclavicular joint. The study was conducted on 62 patients with fracture of clavicle, attending Emergency and Outpatient Department of Orthopedics, Medical College and Hospital. Patients were clinically examined; first aid was given in the form of, cuff and color sling, analgesics, antacids and was subjected to A-P view, Lardotic view radiograph of full length clavicle to decide the plan of definitive management. If needed CT scan and MRI were also taken. In our study out of 62 patients 42 (67.74%) patients sustained trauma due to road traffic accident, 15 (24.19%) patients fall from height and 5 (8.06%) patients from assault. Thus commonest (67.74%) mode of trauma was road traffic accident. Fractures of middle third of clavicle only were included in the study and medial end and lateral end were excluded as per our criteria. None of the patient had bilateral involvement.

Fractures of clavicle are known since ancient time, earliest description of fracture clavicle is found in Egyptian literature in 3550 BC. Hippocrates described fracture clavicle, as early as 400 BC and recorded that it is impossible to maintain reduction without surgical fixation, similar observation have been made by many surgeons in the years to follow. Selected patients were randomly divided in Group I and Group II. Patients of group I were treated by, closed/open reduction &internal fixation by TENS and Group II by open reduction & internal fixation by plate& screws. Patients were followed periodically at 2 weeks, 6 weeks, 3, 6, 12 months, 18 months and 24 months. Clinicians use various criteria to define a nonunion. Nonunion usually describes a fracture that has not adequately healed between stipulated 6 and 9 months after injury; delayed union, a fracture that has not healed after 3 to 6 months. However, some clinicians believe that a clavicular fracture is non-united if the fracture has not adequately healed within 4 months after injury. The constant scores were not significantly different between the two groups in the follow-up period and there was not much alteration after 1 year postoperatively. At final evaluation, the overall results using the constant score were 29 excellent, 2 good in the plate group; while in the TENS group it was 29 excellent, 1 good and 1 poor results.

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The majority of clavicular fractures (80% to 85%) occur in the midshaft of the bone, where the typical compressive forces applied to the shoulder and the narrow cross section of the bone combine and result in bony failure. Patients were clinically examined; first aid was given in the form of, cuff and color sling, analgesics, antacids and was subjected to A-P view, Lardotic view radiograph of full length clavicle to decide the plan of definitive management. If needed CT scan and MRI were also taken. Those requiring surgery were classified as per Allman classification and investigated for fitness for anesthesia and surgery. Six patients had associated skeletal injury three patient had fracture ribs, two had fracture femur one had polytauma (fracture right clavicle, left ulna, right femur). Five cases had CCI (crainio-cervical injury) Most of the cases had no other associated injuries.no associated neurovascular injury were noted. Overall plate had more intra op and post op complications like more blood loss, more operative time, superficial infections, deep infections, implant protuberance, ugly scar, difficult implant removal than TENS fixation. In this study nonunion was equal in both TENS and plate fixation groups.