Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Displaced Clavicular Mid-shaft Fractures: A Prospective Study

Abstract

Objective To compare the difference between MIPO and IMN methods in the treatment of displaced clavicular mid-shaft fractures. Methods A total 163 patients were consecutively enrolled and randomly divided into the MIPO group or the IMN group. Clinical characteristics and outcomes including age, gender, causes of fractures, and AO/OTA type as well as hospitalization time, healing time, and postoperative complications were analyzed. Constant-Murley scores and DASH scores were used for assessment of shoulder joint and upper extremity function, respectively. Results In this study, 82 cases received MIPO and 81 cases received IMN. The mean operation time, mean bleeding volume, mean hospitalization time, and mean healing time showed no significant difference between the MIPO and IMN groups. At 3 months after surgery, Constant-Murley scores were significantly higher and DASH scores were significantly lower in the MIPO group than the IMN group. No significant difference was observed for both indexes at 6 months. The fracture nonunion rate was significantly lower in the MIPO group. No significant difference was found in other complications. Conclusion Both methods were effective for the treatment of displaced clavicular mid-shaft fractures. However, the MIPO method might be better for recovery of shoulder and upper extremity function in the short term and might have a lower nonunion rate.

A Prospective Randomized Study Comparing Functional Outcome in Distal Fibula Fractures between Conventional AO Semitubular Plating and Minimal Invasive Intramedullary “Photodynamic Bone Stabilisation”

“…Commonly known open reduction and internal fixation (ORIF) using various techniques is the standard of care for displaced ankle FX in adults [ 15 , 16 , 17 ]. Generally speaking, a recent advance in the treatment of fractures of different bones was the introduction of intramedullary nails [ 43 , 44 ]. Thus far, the use of intramedullary nailing systems in distal fibula fractures has been investigated under the aspects of FX stabilization, soft tissue management, and complication rates [ 25 , 26 , 27 ].…”

“…Group I patients were treated following the rehabilitation protocols ( Table 1 ) of our trauma department, which allowed partial weight bearing restricted to 20 kg for 6 weeks, using crouches or a medical walking boot, and pain-adapted motion out of the walking boot without limitations, according to the recommendations of the German Society for Orthopedics and Trauma (DGOU) [ 44 ]. After the initial 6 weeks, these patients were allowed to increase the load of weight bearing with the goal to achieve full weight bearing within 10 weeks after surgery.…”

“…Thus far, surgical treatment of FX with IM nailing has already shown promising results in the treatment of various complex fractures of the femur [ 42 ], tibial shaft [ 43 ], and clavicle [ 44 ]; hence, IM nailing has become a standard implant. To the best of our knowledge, there still exists no prospective randomized trial assessing the treatment of distal fibula FX using these modern implants.…”