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Background: The ideal surgical management for Acromioclavicular joint dislocation (ACJ) is debatable and is unsolved as newer and more sophisticated techniques are being continuously evolved. The present study evaluates the functional outcome of ACJ reconstruction using the modified Weaver-Dunn procedure in rural setup where availability of latest implant is difficult. Materials and Methods: 30 patients (20 males, 10 females) with ACJ dislocation, between the age group of 18 years to 48 years (mean age 30 years), were operated using modified Weaver-Dunn procedure at our institute from JUNE 2017 to DECEMBER 2019. The dominant side was involved in 25 patients (17 right side, 8 left side). The mean period from the time of injury to the surgery was 8 days (range 3 to 16 days). All the patients were assessed with Oxford Shoulder Score (OSS) and time required to complete functional return to their work was assessed. Results: At the mean follow up of 6 months, the mean Oxford Shoulder Score improved from 23.36 (± 5.56) to 44.0 (± 4.1), 25 out of 30 patients had satisfactory results, while 5 out of 30 patients had mild shoulder dysfunction using Oxford Shoulder scoring system. Of these 5 patients who had mild shoulder dysfunction, 2 developed ossification around the coracoclavicular ligament and 1 patient had intermittent mild pain without any functional disability, 1 patient had a moderate stiffness at shoulder joint movements, and 1 patient had postoperative superficial infection. Conclusion: ACJ reconstruction using the modified Weaver-Dunn procedure in ACJ dislocation in rural setup is a good method and provides a good functional outcome without the use of latest sophisticated implants and instruments.

Introduction: Traditionally, mid-shaft clavicular fractures were treated non-operatively; however, they have been associated with higher non-union rates and poor functional outcomes in certain types of fractures. We aimed to objectively compare the surgical outcomes in patients with mid-shaft clavicular fracture treated either with nailing or plating and assess their functional outcomes over a follow up period of one year. Methodology: Our prospective sample was chosen from a pool of patients visiting casualty of our Hospital for fracture clavicle between March 2015 and March 2017. Patients either underwent open reduction and plate fixation with a 3.5 mm superior clavicular plate or a 2.0 mm to 3.5 mm titanium nail. Intraoperative parameters and postoperative functional outcomes over a period of 12 months were compared between the two patient groups. Results: During the study period 65 patients with clavicular fracture were operated in our department, 35 patients with dynamic compression plating and rest intramedullary fixation and nailing. Patients undergoing nailing had a significantly lesser operative time, incision length, blood loss and hospital stay as compared to plating (p value < 0.001). Mean Constant Murley score throughout the follow up period was higher in the group of patients undergoing plating, though the difference was not significant at any follow up point. Nailing was associated with more frequent implant migration and irritation of skin and there was need of significantly more number of intraoperative image intensifier shoots, resulting in higher radiation exposure, as compared to plating. Nailing and plating resulted in mean shortening of clavicle length by 0.5 cm (range 0.4 to 2.1 cm) and 0.2 cm (range 0.2 to 1.8 cm) respectively. Conclusions: We found no difference in the functional outcome and nonunion rates between nails and plates fixation for displaced midshaft clavicular fractures but nailing was associated with higher rates of complications. Keywords: Clavicle fracture, midshaft, intramedullary fixation, plate fixation, osteosynthesis, trauma