Flexible intramedullary nailing for stabilization of displaced midshaft clavicle fractures: Technique and results in 87 patients

Kettler, M.; Schieker, Matthias; Braunstein, Volker; König, Matthias; Mutschler, Wolf

doi:10.1080/17453670710014022

Cited by 86 publications

(78 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lateral perforation was reduced to just one case by reducing technical errors using intraoperative oblique radiographs and manual implant passage, as well as limited postoperative ROM. Medial migration was observed on average in 10% (1%-18%) in the literature (Table 1) [8,10,16,26]. In our study, no medial migration of the TEN occurred since this was prevented by the end cap.…”

Section: Discussionsupporting

confidence: 49%

“…These findings are comparable with the results of our second patient group. As a minimally invasive method, titanium elastic nailing causes considerably less damage to soft tissue than plate osteosynthesis, with nonunion rates of 0% to 2.6% for titanium elastic nailing and 3.2% for plate osteosynthesis [1,8,10,16,26].…”

Section: Discussionmentioning

confidence: 99%

“…Kettler et al [10] 87 10 (11.5%) Lateral (n = 3) and medial (n = 1) migration, nonunion (n = 2), secondary shortening of [ 1 cm (n = 2), malunion (n = 2)…”

Section: Methodsmentioning

confidence: 99%

“…Thereafter, the total complication rate still remained at 60% [2], which we considered unacceptable. Given the potential advantages of a minimally invasive operation with few complications that achieves normal shoulder function after surgery [6,10,15,16,26], we thought it important to develop an approach to reduce the complication rate. Because mechanical complications (migration, breakage, dislocation) were most frequent, we considered which possible technical errors during surgery or mechanical overuse problems during the followup could cause these complications.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Can Complications of Titanium Elastic Nailing With End Cap for Clavicular Fractures Be Reduced?

Frigg

Rillmann²,

Ryf³

et al. 2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background We found treatment of clavicular midshaft fractures using titanium elastic nails (TENs) in combination with postoperative free ROM was associated with a complication rate of 78%. The use of end caps reduced the rate to 60%, which we still considered unacceptably high. Thus, we explored an alternative approach. Questions/purposes We investigated whether (1) the complication rate could be reduced by cautious lateral advancement of the TENs, intraoperative oblique radiographs to rule out lateral perforation, and limited ROM postoperatively; (2) fluoroscopy time could be reduced; and (3) shoulder function would be reasonable. Patients and Methods From March 2006 to December 2009, we treated 44 patients with midshaft clavicular fractures with TENs and end caps. In the first group (n = 15), the TEN was advanced laterally using an oscillating drill. The patients were permitted free ROM. In the second group (n = 29), the TEN was advanced by hand, conversion to open reduction followed two failed closed attempts and lateral perforation was checked with an intraoperative oblique radiograph. Furthermore, anteversion and abduction of the shoulder were limited to 90°for the first 6 weeks. Minimum followup was 12 months (mean, 16.7 months; range, 12-28 months). Results The total complication rate was reduced from nine of 15 in the first group to five of 29 in the second group. Medial perforations ceased with the use of the end cap. Fluoroscopy time was reduced from a mean of 10 to 4 minutes by converting to open reduction after two failed closed attempts. All but three patients exhibited full shoulder ROM at three months and these three had a slight deficit of 10°to 20°in anteversion and/or abduction. At last followup, the mean American Shoulder and Elbow Surgeons score was 92 (range, 88-100) and the Disability of the Arm, Shoulder, and Hand score 1.4 (range, 0-12.5). Conclusions Cautious insertion of the TENs, intraoperative oblique radiographs, and limiting the ROM for 6 weeks postoperatively reduced the complication rate. Using TENs with end caps for midshaft clavicular fractures is minimally invasive while associated with comparable complication rates and function to plate osteosynthesis. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

“…Kettler et al [10] 87 10 (11.5%) Lateral (n = 3) and medial (n = 1) migration, nonunion (n = 2), secondary shortening of [ 1 cm (n = 2), malunion (n = 2)…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Can Complications of Titanium Elastic Nailing With End Cap for Clavicular Fractures Be Reduced?

Frigg

Rillmann²,

Ryf³

et al. 2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…The medial segment of the clavicle will be fixed using the anterior holes and the lateral using the superior ones these plates. These plates are called the superior anterior clavicle plates [3,6]. All these implants provide the opportunity for minimal invasive insertion using two small incisions and due to their low…”

Section: Replymentioning

confidence: 99%

Mid- Clavicular Fractures- A Change in Treatment Strategies?

Kumar

2009

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Schultergürtel

Meenen

2011

Praxis Der Kinder- Und Jugendtraumatologie

View full text Add to dashboard Cite

Flexible intramedullary nailing for stabilization of displaced midshaft clavicle fractures: Technique and results in 87 patients

Abstract: Flexible intramedullary nailing, a minimally invasive technique for stabilization of displaced midshaft clavicle fractures, has minor risks and complications.

Cited by 86 publications

References 21 publications

Can Complications of Titanium Elastic Nailing With End Cap for Clavicular Fractures Be Reduced?

Can Complications of Titanium Elastic Nailing With End Cap for Clavicular Fractures Be Reduced?

Mid- Clavicular Fractures- A Change in Treatment Strategies?

Schultergürtel

Contact Info

Product

Resources

About