MIDSHAFT CLAVICLE FRACTURE

COMPARISON OF POLY ARM SLING AND FIGURE OF EIGHT BANDAGE

Abstract

Introduction: Fracture of clavicle is common, occurring most commonly in
males accounting for approximately 2.5%of all fracture presenting to orthopedic surgeon.1 This
study has been conducted to compare the broad arm sling and figure of eight bandage in the
first 21 days of treatment with primary outcome measure of pain and disability. Study Design:
Comparative study. Setting: Department of orthopedic surgery, Dow International Medical
College, Dow University hospital. Period: February 2015-2016. Material and Methods: 60
eligible patients with a mean age of (15-60 years) were randomized to conservative treatment
with either a broad arm sling or figure of eight bandage. After detailed counseling taking informed
consent we did non stratified randomization in blocks of two using the sealed envelope method.
Patients were kept in strict follow up to complete the outcome measures the next day and on
day seven, fourteen and twenty one. On each visit a Performa was filled known as SPADI having
two components of pain and disability and VAS on day one, seven, fourteen and twenty one.
Results: Seventy patients were enrolled initially, out of them ten patients were dropped out
due to different reasons. Of the remaining 60 patients 30 were treated with broad arm sling and
30 were treated with figure of eight bandage. The two groups were randomized fulfilling the
inclusion criteria. The Mean VAS on the first day of treatment in the broad arm sling group was
5.433 SD 1.04 (p= 0.034, 95% CI 0.10 -2.46) where as in figure of eight group was 8.9 (SD 10.8).
On subsequent visits (Day 7,14,21) VAS of broad arm sling was 3.83, 1.40,1 whereas figure of
eight was 5.76, 4.3, 3.469. This result clearly shows good pain control in broad arm sling group
as compared to the figure of eight group. The mean SPADI on the first day of treatment was
94.52(SD 2.273) in broad arm sling group, on the other hand it was 93.87(SD 2.239) in figure of
eight group. In follow up visits of day 7, 14 and 21 score was as follows in broad arm group 3.83
(SD 0.79), 1.4(SD 0.49), 1(SD 0.0), it was 5.76(SD 1.04), 4.3(SD 0.740), 3.4(SD0.68) in figure of
eight group. It also shows better result in terms of pain and functional outcome. Conclusion:
Fracture clavicle is still managed conservatively in majority of the cases, either with the figure of
eight bandage or polyarm sling. Patient’s outcome in terms of pain management and functional
range of motion in poly arm sling is better than figure of eight bandage.