Application of an external fixator for acute displaced mid-clavicle fracture

Abstract

Objective To evaluate clinic application of an external fixator in management of acute displaced mid-clavicle fracture and infected clavicle non-union.Methods From June 2002 to May 2009,7 cases of displaced mid-shaft clavicle fracture were treated in our department.They were 4 men and 3women,aged from 25 to 42 years(average,33.7 years).By Edinburgh classification,they were all type 2B1.Five acute cases complicated with multiple injuries received closed reduction and fixation with an Orthofix M511 external fixator on the day of injury.One open clavicle fracture and one infected clavicle nonunion received fixation with a Hoffman Ⅱ fixator at a proper time.Results All the patients were followed up for a mean time of 14.1 months (from 11 to 18 months).The mean duration of retaining the external fixator was 64.4days(from 53 to 90 days).Their mean Constant score was 94.3 points at the last follow-up.All the fractures healed in their anatomical position.All the patients were satisfied with the shape of their repaired shoulder and their treatment outcome.Complications were observed in 3 cases,one hypertrophic scar at the pin track,one loss of reduction and one superficial pin track infection.Conclusion External fixation is a reliable alternative for management of open clavicle fracture,infected clavicle nonunion and acute displaced mid-clavicle fracture with severe associated injury which does not tolerate standard open reduction and internal fixation. Key words: Clavicle; Fractures; External fixator