Elastic stable intramedullary nailing of midclavicular fractures in adults: 32 patients followed for 1–5 years

Mueller, Marcus; Burger, C.; Florczyk, A.; Striepens, Nadine; Rangger, C.

doi:10.1080/17453670710014013

Cited by 50 publications

(43 citation statements)

References 9 publications

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“…4,6,10 Rockwood clavicle pins appear to be as effective as plates in achieving union and maintaining length in both the acute and delayed Duncan et al realized first that most papers document local wound complications, but there is a lack of outcomes and treatment protocols for the management of septic complications after clavicle fracture.…”

Section: Discussionmentioning

confidence: 99%

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Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Dömös

Tytherleigh-Strong

Rensburg

2017

Journal of Orthopaedic Surgery

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Purpose: Adult mid-shaft clavicle fractures are common injuries. For displaced fractures, open reduction with plate or intramedullary (IM) fixation is the widely used techniques. All methods have their own potential drawbacks, especially related to local soft tissue complications. There is little information about outcome and management of local wound complications after clavicle fracture fixations. Methods: Ninety-seven patients underwent open reduction and internal fixation, 17 were treated with IM screw fixation and 80 with plate fixation. Wound complication occurred in eight patients (8.2%) and rates differed significantly between IM and plate fixations (29.4% vs. 3.8%). Patients were assessed on average 58.3 months with visual analogue pain scores (VASs), Oxford Shoulder Score (OSS), and QuickDash (QD) score. Results: Five patients had wound breakdown and three patients had wound erythema. In seven patients with stable fixation, it was possible to "dress and suppress" with average 3 weeks of oral antibiotics. One patient had unstable fixation and required longer antibiotic treatment with early screw removal. One patient developed a chronic discharging wound, requiring debridement and later plate removal. At final follow-up, all wounds remained healed, bony union was achieved in all. The average scores were: VAS 1, OSS 46, and QD 4.5. Conclusions: Good function with dry healed wound and united clavicle can be achieved. Further studies are required to investigate the difference in soft tissue complication rates, which may be due to the IM technique of retrograde drilling with a guide wire and due to aseptic thermal bone necrosis, rather than true infection.

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Section: Discussionmentioning

confidence: 99%

“…2 Operative implants and techniques vary and include different intramedullary (IM) osteosynthesis and plate fixation. 1,3,4 The commonest operative complications consisted of local hardware irritation or pin protrusion and wound problems or infection.…”

Section: Introductionmentioning

confidence: 99%

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Dömös

Tytherleigh-Strong

Rensburg

2017

Journal of Orthopaedic Surgery

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“…Previous timelines for regaining full range of motion and function after surgery were unclear. 24,25 We present a successful ORIF surgical repair and specific timeline for return to functional, competitive activity.…”

Section: Discussionmentioning

confidence: 99%

Clavicular Fracture in a Collegiate Football Player: A Case Report of Rapid Return to Play

Rabe

Oliver

2011

Journal of Athletic Training

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Objective: To present the case of surgical treatment and rehabilitation of a midshaft clavicular fracture in a National Collegiate Athletic Association Division I football athlete. Background: While attempting to catch a pass during practice, the athlete jumped up and then landed on the tip of his shoulder. On-the-field evaluation was inconclusive, with a sideline evaluation diagnosis of clavicular fracture. Postinjury radiographs revealed a midshaft clavicular fracture. Differential Diagnosis: Spiral oblique midshaft clavicular fracture. Treatment: The sports medicine staff discussed surgical and nonsurgical options. A surgical procedure of internal fixation with an 8-hole plate was performed. Uniqueness: Surgical treatment for clavicular fractures is becoming increasingly common. This is the first report of an advanced rehabilitation protocol for surgical repair. We suggest that new rehabilitation protocols for clavicular repairs be investigated now that surgical treatment is being pursued more frequently. Conclusions: More aggressive treatment procedures and rehabilitation protocols for clavicular fractures have evolved in recent years. With these medical advancements, athletes are able to return to play much more quickly without compromising their health and safety.

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“…Similar complications have been described with intramedullary pinning [21] . Minimally invasive elastic titanium nailing was established as an alternative to plate fixation [25,26]. Jubel et al [8] showed that the correction of clavicular shortening is a pre-requisite of good functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Antegrade flexible intramedullary nailing for fixation of displaced midshaft clavicle fractures

S.M¹,

Lingaraj²,

Zachariah³

et al. 2014

IOSRJDMS

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Abstract:Introduction: Fractures of the clavicle are common injuries with an incidence of 5-10% of all fractures [1]. These fractures are generally managed conservatively. Titanium elastic nails are a promising minimally invasive treatment for displaced mid-clavicular fractures, which may be an alternative to plate fixation or even nonoperative treatment. The aim of the present study was to evaluate the functional and radiological results of intramedullary fixation of mid-clavicular fractures. Methods: Between January 2007 and June 2013, 48 patients with type A and type B middle third clavicle fractures (OTA Classification) underwent flexible intramedullary nailing with titanium elastic nail. Implant removal was performed in all the patients after the fracture united completely. Results: The mean constant shoulder score for 47 patients at 6 weeks was 56.98 (range: 44-72), at 3 months was 91.25 (range: 54-98), at 6 months was 96.38 (range:64-100), at 12 months was 98.75 (range:68-100), at 18 months was 99.50 (range:78-100), and at the end of 24 months it was 99.58 (range:80-100). Conclusion: Flexible intramedullary nailing, a minimally invasive technique for stabilization of displaced midshaft clavicle fractures is a simple procedure with excellent functional outcome in terms of quick return to sporting activities and a high patient satisfaction rate.

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Elastic stable intramedullary nailing of midclavicular fractures in adults: 32 patients followed for 1–5 years

Abstract: Intramedullary stabilization of midclavicular fractures with a titanium elastic nail is a minimally invasive technique with good cosmetic and functional results. Intramedullary fixation can be seen as an alternative to plate fixation and nonoperative treatment.

Cited by 50 publications

References 9 publications

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Clavicular Fracture in a Collegiate Football Player: A Case Report of Rapid Return to Play

Antegrade flexible intramedullary nailing for fixation of displaced midshaft clavicle fractures

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