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

Abstract

Background: Literature on the functional outcomes following the treatment of closed, displaced midshaft clavicle fractures in adolescents is fairly limited. These fractures have traditionally been treated non-operatively; however, recent literature in adults shows improved outcomes with operative treatment, and it has been suggested that these results may translate to adolescents.

Functional and radiological evaluation of clavicular fractures managed by elastic nailing: A prospective study

“…Bithrey JW and Van der Merwe JF (2017) reported 9 right and 6 le clavicle fractures were assessed. Our ndings were contrasting to the above mentioned studies and this may be by a ma er of chance that the majority of patients le side was affected [2]. In the present study the mean difference DASH Score at different follow up duration with respect to the mean DASH score at 4 weeks was taken and the association was found to be signi cant (p less than 0.05).…”

“…Clavicle is the most commonly fractured bone usually, accounting for up-to 12% of all adult fractures [1]. Middle 3rd fractures of the clavicle bone comprise around 80% of all clavicle fractures [2]. Clavicle fractures are normal with male dominance in active and early age groups (male female ratio is 2:1) [3].…”

“…Displaced mid-sha clavicle fractures have historically been overlooked as it was believed that these fractures uniformly heal without complications. Modern literature has confronted this belief, and many studies had disclosed unacceptably high non-union rates of 15.1% as well as related pain, strength loss and quick fatigability when these were administered with conservative methods [2]. e treatment grade for almost all clavicle fractures has been non-operative in nature, frequently consisting of a simple sling [4].…”

“…Surgical procedures commonly used to repair DMCF (Displaced Midsha Clavicular Fracture) internally are plating & intramedullary nailing with titanium elastic nail (TEN). Intramedullary nailing of the clavicle has been shown to have considerable bene ts over other forms of xation as there is limited periosteal stripping and minimal compression of the periosteal blood supply which promotes union [2]. us elastic intra-medullary nail is a safe, minimally invasive, promotes rapid healing with good cosmesis and provides an excellent functional outcome with fewer complications in terms of patient satisfaction [5].…”

Safe Clavicle Fracture Surgery

“…1,12 The operative treatment with a titanium elastic nail is claimed to be a safe, less invasive, and trustworthy treatment method for displaced uncomminuted midshaft clavicle fractures in adolescents. 13 Considering the unstable nature of the lateral third clavicle fracture, the surgical treatment is justified by many surgeons at the moment with good functional outcome. 4, [14][15][16][17] Because of the rarity of medial clavicle fracture, the number of operative reports for this type of fracture is limited in the medical literature.…”