الفهرس 
I. INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
A clavicle fracture is common traumatic injury that comprises about 45% of
shoulder girdle injuries and 5% of skeletal injuries. In most cases, the direct hit occurs
from the lateral side towards the medial side of the bone.
The lateral or acromial end of the bone is flattened and articulates with the medial
side of the acromion, whereas the medial or sternal end is enlarged and articulates with
the clavicular notch of the manubrium sterni and the first costal cartilage. The shaft is
gently curved and in shape being convex forwards in its medial two-thirds and concave
forwards in its lateral third.
The subclavian vein runs directly below the subclavius muscle and above the first
rib. More posterior lies the subclavian artery and the brachial plexus, separated from the
vein and clavicle by additional layer of the scalenus anterior muscle medially.
The clavicle contributes significantly to the power and stability of the arm and the
shoulder girdle, plays an important role in range of motion of the arm, acts as a bony
framework for muscle origin and insertion, provides skeletal protection for adjacent
neurovascular structures and the superior aspect of the lung, aids in respiration and
gives a cosmetic appearance to the shoulder.
Fractures can occur at any part of the clavicle. However, the vast majority (69-
82%) occur in the midshaft, at or near the junction of the middle and outer third. This is
due to two factors: firstly, this is the thinnest part of the bone, and secondly, it is the
only part of the bone not reinforced by attached musculature and ligaments.
Complications of clavicular fractures include skin or soft tissue compromise,
neurovascular injury, refracture, arthritis in the acromio-clavicular or sterno-clavicular
joints, mal-union and non-union.
A precontoured clavicle plate is a plating system that is anatomically
precontoured which assists in restoring the original structure of the patient’s anatomy
with little or no bending of the plate by the surgeon at the time of surgery. Avoiding the
need to bend a precontoured clavicle plate saves valuable operating room time. The
recent introduction of anatomically contoured clavicle plates may reduce the need for
hardware removal.
The advantages with these plates include strong fixation due to locking between
the screw and plate, and blood supply preservation due to minimal contact between
plate and cortical bone. When LCPs are used to treat clavicle midshaft fractures, the
risks of injury to the subclavicular artery or brachial plexus can be reduced because
fixation can be achieved without the tip of the screw reaching the opposite bone cortex
and periosteal stripping can be minimized to promote rapid union. It is believed that the
surgery time can be reduced using LCPs because accurate plate contouring is not
necessary and periosteal stripping could be minimized using self-tapping screws.
Complications of plate fixation include infection, wound dehiscence, keloid
formation, and refracture after fixation.
The aim of this work was to study the results of open reduction and internal
fixation in the treatment of displaced fractures of the middle third of the clavicle by
Summary