Intramedullary Fixation of Diaphyseal Clavicle Fractures Using the Rockwood Clavicle Pin: Review of 86 Cases

Marlow, William J; Ralte, Peter; Morapudi, Syam; Bassi, R.; Fischer, Jochen; Waseem, Mohammad

doi:10.2174/1874325001206010482

Cited by 15 publications

(18 citation statements)

References 31 publications

(34 reference statements)

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“…1). In total, 10 studies concerning the Rockwood (DePuy, Warsaw, IN, USA) and Hagie pin (Smith & Nephew, Memphis, TN, USA) were identified and included in the analysis (two level I, [15,16] two level III [17,18] and six level IV [19][20][21][22][23][24] studies). These devices were evaluated together since they are essentially the same; they both consist of the exact same stainless-steel pin, with a cancellous and machine thread end, and two nuts.…”

Section: Resultsmentioning

confidence: 99%

“…This may be explained by the two bulky nuts at the posterolateral aspect of the clavicle where the pin is inserted and is has been reported to be an important disadvantage of the implant. [15,19,22] For the Sonoma CRx no reports on hardware irritation were found since this device has no extra-cortical prominences and is fully embedded in the clavicular cortex.…”

Section: Discussionmentioning

confidence: 99%

“…The functional outcome scores reported were heterogeneous and therefore not comparable. Only two studies reported a Constant-Murley (92.1±6) [15] or DASH (5.9,) [19]. Other functional outcome scores reported were the Oxford Shoulder Score (45.2±2.3), [15] L'Insalata (95.5 ±7.3), [16] and ASES (88.6 and 89).…”

Section: Studies Concerning the Rockwood Pin And Hagie Pinmentioning

confidence: 99%

See 2 more Smart Citations

Functional Outcomes and Complications of Intramedullary Fixation Devices for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis.

Hoogervorst¹,

Dam²,

Hannink³

2020

Preprint

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Background An alternative to the current gold standard in operative treatment of displaced midshaft clavicle fractures (DMCF) using plate osteosynthesis, is internal fixation by means of intramedullary fixation devices. These devices differ considerably in their specifications and characteristics. The aim of this systematic review is to generate an overview of functional outcomes and complications in the management of DMCF per available intramedullary device.Methods A systematic review was conducted to identify all papers reporting functional outcomes, union rates and/or complications using an intramedullary fixation device for the management of midshaft clavicle fractures. Multiple databases and trial registries were searched from inception until February 2020. Meta-analysis was conducted based on functional outcomes and type of complication per type of intramedullary fixation device. Pooled estimates of functional outcomes scores and incidence of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates were rated and described according to the recommendations of the GRADE working group.Results Sixty-seven studies were included in this systematic review. The majority of studies report on the use of Titanium Elastic Nails (TEN). At 12 months follow up the Titanium Elastic Nail and Sonoma CRx report an average Constant-Murley score of 94.4 (95%CI 93-95) and 94.0 (95%CI 92-95) respectively (GRADE High). The most common reported complications after intramedullary fixation are implant-related and implant-specific. For the TEN, hardware irritation and protrusion, telescoping or migration, with a reported pooled incidence 20% (95%CI 14-26) and 12% (95%CI 8-18), are most common (GRADE Moderate). For the Rockwood/Hagie Pin, hardware irritation is identified as the most common complication with 22% (95%CI 13-35) (GRADE Low). The most common complication for the Sonoma CRx was cosmetic dissatisfaction in 6% (95%CI 2-17) of cases (GRADE Very low).Conclusion Although most studies were of low quality, good functional results and union rates irrespective of the type of device are found. However, there are clear device-related and devicespecific complications for each. The results of this systematic review and meta-analysis can help guide surgeons in choosing the appropriate operative strategy, implant and informing their patient.3

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Studies Concerning the Rockwood Pin And Hagie Pinmentioning

confidence: 99%

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Functional Outcomes and Complications of Intramedullary Fixation Devices for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis.

Hoogervorst¹,

Dam²,

Hannink³

2020

Preprint

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“…5 Wijdicks et al suggested that infection is defined as redness, swelling, purulent discharge, a positive wound culture, and/or when prescription of antibiotics was given, and irritation was caused by prominence or protrusion of the implant material. 6 There are only few articles [7][8][9][10][11][12][13] reporting on these complications and even fewer 14,15 explore their treatments and outcomes, especially with IM cannulated screws. 16,17 Our study was designed to focus on the treatment and outcome of patients with clavicle fractures treated with open reduction and internal fixation, who had local wound complications.…”

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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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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“…Through a retrograde intramedullary nailing of the screw, a technique introduced by Boehme et al, 12) many authors have shown good clinical outcomes. [13][14][15][16] We devised an anterograde intramedullary nailing approach to treat clavicle shaft fractures and used that along with the previously described retrograde approach. The purpose of this study was to investigate and compare the outcomes of retrograde intramedullary screw fixation and of anterograde intramedullary screw fixation for clavicle shaft fractures.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Screw Fixation for Clavicle Shaft Fractures: Comparison of the Anterograde versus the Retrograde Technique

Rhee¹,

Cho²,

Cho³

et al. 2016

Clinics in Shoulder and Elbow

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Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome.

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Intramedullary Fixation of Diaphyseal Clavicle Fractures Using the Rockwood Clavicle Pin: Review of 86 Cases

Cited by 15 publications

References 31 publications

Functional Outcomes and Complications of Intramedullary Fixation Devices for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis.

Functional Outcomes and Complications of Intramedullary Fixation Devices for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis.

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

Intramedullary Screw Fixation for Clavicle Shaft Fractures: Comparison of the Anterograde versus the Retrograde Technique

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