Surgical treatment of midclavicular fractures: a prospective comparison of Knowles pinning and plate fixation

Although several surgical techniques for midclavicular fractures have been reported, Knowles pinning has rarely been compared with plating. The purpose of this study is to compare the clinical results of these two alternative techniques. There were 88 patients with midclavicular fractures surgically treated with either a Knowles pin or a plate. All patients were followed up for 12 months with a shoulder score evaluation. The Knowles pin group included 56 patients, with an average age of 40.1 years. The plate group included 32 patients, with an average age of 38.2 years. Both groups were similar in injury mechanism and fracture types (all p values>0.5). Plating has a significantly longer operation time, larger wound incision, higher pain level, more analgesic use, more complications and more symptomatic hardware (all p value<0.05). The shoulder score, union rate and healing time are not significantly different between the two groups (all p values>0.2). In conclusion, if the surgery of mid-third clavicular fractures is indicated, fixation with a Knowles pin has more advantages than plate fixation.