Operative Treatment of Dislocated Midshaft Clavicular Fractures: Plate or Intramedullary Nail Fixation?

Abstract

The patients in the plate-fixation group recovered faster than the patients in the intramedullary nailing group, but the groups had similar results at six months postoperatively and the time of final follow-up. The rate of complications requiring revision surgery was low. Implant-related complications occurred frequently and could often be treated by implant removal.

Plate Versus Intramedullary Fixation Care of Displaced Midshaft Clavicular Fractures

“…The remaining 7 studies 20 – 26 were included in this meta-analysis. Of the 7 studies, 1 study 24 was a multicenter randomized controlled clinical trial and 6 were from a single investigational site; all randomized clinical trials enrolled patients with completely displaced midshaft clavicular fractures (Figure 1 ).…”

“…The risk of bias was demonstrated graphically in Figure 2 and summarized in Figure 3 . The randomization technique was mentioned in 5 studies, 21 , 22 , 24 – 26 and information of allocation concealment was not available for 2 studies. 20 , 23 Blinding was hardly used in open surgery trials and no 1 study was blinded in the assessment of outcome; thus, the term “blinding of outcome assessment” was assessed as “high risk” for all the 7 studies.…”

Outcomes of treatment of displaced midshaft clavicle fractures in adolescents using titanium elastic nails

“…The mean time to union in our series was the same as that of Chen et al and comparable with that of conventional plating. 33,35,36,38 In a 2015 meta-analysis of plate versus intramedullary fixation of midshaft clavicle fractures, Zhang et al showed that intramedullary fixation was associated with a reduced surgery time, smaller incision, faster union rate and better shoulder function at six months. Fewer metal-ware complications and re-fracture after metal-ware removal was also noted.…”

Introducing the Surgical Therapeutic Index in trauma surgery: an assessment tool for the benefits and risks of operative fracture treatment strategies

“…In the interest of brevity we refer to the study protocol and previously reported objective and patient-oriented outcome for full description of in-and exclusion criteria, operative procedures and (functional) outcome parameters. 16,17 A total of 58 patients were enrolled for PF and 62 for IMF. At baseline, there were no differences between the two groups (Table I).…”