ShoulderSurgical management of uncomplicated midshaft clavicle fractures: a comparison between titanium elastic nails and small reconstruction plates
Section snippets
Methods
We conducted a retrospective, case-controlled study on patients with clavicular fractures that were surgically treated at our hospital from January to December 2007. Open fractures, complex comminuted fractures (type 2B2), nonunion after 6 months of conservative therapy, and cases in which treatment was delayed for more than 3 weeks after injury were excluded because such cases are considered a strong indication for plate fixation. In addition, cases with neurovascular injury or multiple
Results
On the basis of the previously described criteria, the records of 57 patients with acute, displaced (>1 cm), closed midshaft clavicular fractures that were operated on within 2 weeks after injury were included in this analysis. There were 28 male and 29 female patients ranging in age from 14 to 66 years, and there were 25 patients in the TEN group and 32 in the SRP fixation group. Table I presents a summary of the demographic characteristics of the patients in each group. There were no
Discussion
We designed this retrospective study to compare the outcomes of patients with uncomplicated midshaft clavicle fractures treated with TEN fixation or 3.5-mm reconstruction plate fixation and found that operation time, wound size, blood loss, length of hospitalization, and subjective time to pain relief were less for the TEN group than for the SRP fixation group (P < .001 for all). Patients in the TEN group showed greater shoulder ROM and higher Constant scores than those in the SRP group up to
Conclusions
The results of this study comparing outcomes of TEN and plate fixation for uncomplicated midshaft clavicular fractures indicate that TENs provide adequate fixation and faster relief of pain and return to normal function of the affected shoulder.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
References (22)
Evaluation and treatment of distal clavicle fractures
Clin Sports Med
(2003)- et al.
Nonunion of the clavicle treated with plate fixation: a review of forty-seven consecutive cases
J Shoulder Elbow Surg
(2008) - et al.
Normalization of the Constant score
J Shoulder Elbow Surg
(2005) - et al.
Long-term functional outcome assessment of plate fixation and autogenous bone grafting for clavicular non-union
Injury
(2004) - et al.
Percutaneous treatment of insufficiency fractures: principles, technique and review of literature
Skeletal Radiol
(2010) - et al.
Acute management of clavicle fractures. A long term functional outcome study
Acta Orthop Belg
(2008) - et al.
A clinical method of functional assessment of the shoulder
Clin Orthop Relat Res
(1987) - et al.
Intramedullary nailing of clavicular midshaft fractures with the titanium elastic nail: problems and complications
Am J Sports Med
(2009) - et al.
Clavicle fractures: individualizing treatment for fracture type
Phys Sportsmed
(2003) Acute midshaft clavicular fracture
J Am Acad Orthop Surg
(2007)
Elastic stable intramedullary nailing of midclavicular fractures in athletes
Br J Sports Med
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Review board approval for this study was attained from the Institutional Review Board of Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.