Introduction: Recently, intramedullary nailing for displaced middle third
fractures of clavicle has received wide attention. Though open nailing has been
widely described, closed nailing finds less mention. This paper therefore aims
to study the outcome of closed titanium elastic nailing for displaced
mid-clavicular fractures. Material and Methods: This was a prospective study of
34 patients with displaced middle third clavicle fracture who underwent closed
intramedullary nailing with titanium elastic nail at a tertiary care centre.
The operative time, length of incision, time for radiological union, pain and
functional outcome after union were noted. Results: The mean operative time was
34.33 mins. The mean time of discharge was 2.25 days. The average time of
radiological union was 10.23 weeks. All the patients achieved full, painless
range of motion of the ipsilateral shoulder. The average Constant-Murley score
at 12 months was 94.28 indicating excellent result. Conclusion: Closed titanium
elastic nailing offers a safe and minimally invasive method of fixation for
fractures of middle-third clavicle with excellent functional outcome.
Wijdicks, F.J., Van der Meijden, O.A., Millett, P.J., et al. (2012) Systematic Review of the Complications of Plate Fixation of Clavicle Fractures. Archives of Orthopaedic and Trauma Surgery, 132, 617-625. http://dx.doi.org/10.1007/s00402-011-1456-5
Lee, Y.-S., Huang, H.-L., Lo, T.-Y., et al. (2008) Surgical Treatment of Midclavicular Fractures: A Prospective Comparison of Knowles Pinning and Plate Fixation. International Orthopaedics (SICOT), 32, 541-545. http://dx.doi.org/10.1007/s00264-007-0352-7
Assobhi, J.E.H. (2011) Reconstruction Plate versus Minimal Invasive Retrograde Titanium Elastic Nail Fixation for Displaced Midclavicular Fractures. Journal of Orthopaedics and Traumatology, 12, 185-192.
Marsh, J.L., Slongo, T.F., Agel, J., et al. (2007) Fracture and Dislocation Classification Compendium—2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee. Journal of Orthopaedics and Traumatology, 21, S1-S133. http://dx.doi.org/10.1097/00005131-200711101-00001
Smekal, V., Oberladstaetter, J., Struve, P., et al. (2009) Shaft Fractures of the Clavicle: Current Concepts. Archives of Orthopaedic and Trauma Surgery, 129, 807-815. http://dx.doi.org/10.1007/s00402-008-0775-7
Kleweno, C.P., Jawa, A., Wells, J.H., et al. (2011) Midshaft Clavicular Fractures: Comparison of Intramedullary Pin and Plate Fixation. Journal of Shoulder and Elbow Surgery, 20, 1114-1117. http://dx.doi.org/10.1016/j.jse.2011.03.022
Chen, Y.F., Wei, H.F., Zhang, C., et al. (2012) Retrospective Comparison of Titanium Elastic Nail (TEN) and Reconstruction Plate Repair of Displaced Midshaft Clavicular Fractures. Journal of Shoulder and Elbow Surgery, 21, 495-501. http://dx.doi.org/10.1016/j.jse.2011.03.007
Duan, X., Zhong, G., Cen, S., et al. (2011) Plating versus Intramedullary Pin or Conservative Treatment for Midshaft Fracture of Clavicle: A Meta-Analysis of Randomized Controlled Trials. Journal of Shoulder and Elbow Surgery, 20, 1008-1015. http://dx.doi.org/10.1016/j.jse.2011.01.018
Liu, H.H., Chang, C.H., Chia, W.T., et al. (2010) Comparison of Plates versus Intramedullary Nails for Fixation of Displaced Midshaft Clavicular Fractures. Journal of Trauma-Injury Infection & Critical Care, 69, E82-E87. http://dx.doi.org/10.1097/TA.0b013e3181e03d81
Smekal, V., Irenberger, A., Attal, R.E., et al. (2011) Elastic Stable Intramedullary Nailing Is Best for Mid-Shaft Clavicular Fractures without Comminution: Results in 60 Patients. Injury, 42, 324-349. http://dx.doi.org/10.1016/j.injury.2010.02.033
Kraus, T.M., Martetschlaer, F., Schrodl, C., et al. (2011) Elastic Stable Intramedullary Nailing of Clavicular Midshaft Fractures: Comparison of Open vs Closed Fracture Reduction. Article in German, Unfallchirurg.