Abstract
ObjectiveTo evaluate and present the effectiveness of this innovatively designed, elastic locking intramedullary nail (ELIN) in fixation of clavicle fractures.MethodsThe study included 38 patients from July 2014 to July 2017. All of them received intramedullary fixation treated with ELIN, 22 were males and 16 females. The mean age of the patients was 54 years. There were twenty right‐side and 18 left‐side clavicular fractures. Radiographs were taken to assess the fracture type: 21 were type A, 16 type B, and one type C. General anesthesia or cervical block was given to all patients. A small incision of 3–5 cm was given only to those who needed mini‐open reduction. The administration of ELIN and reduction of the fracture was made sure with a C arm machine. After a follow‐up of 8 to 33 months, the clinical outcomes were assessed and evaluated. The constant scores and disabilities of the arm, shoulder and hand questionnaire (DASH) were used to determine the outcomes and functional status of the patients. The study was done accordingly to the guidelines provided by the ethics committee.ResultsMean operation time was 25.63 min. Mean follow‐up time was 16.5 months. The rate of closed reduction and open reduction was 84% and 16% respectively. There was no shortening of the clavicle. There was no breakage of the nail, though bending of the nail occurred in one patient. Superficial skin infection occurred in three patients at insertion points or the nail tip which was embedded subcutaneously. Skin erosion with nail exposure occurred in a patient with no significant infection. All the other patients had excellent shoulder function. A mini scar was observed in seven patients all the other patients had no scar. Asymmetry was observed in three patients. The mean Constant score was 98.47 and the mean DASH score was 1.55 at the last follow‐up. The implant was removed in all the patients.ConclusionClavicular fractures treated with ELIN is minimally invasive, which presents a safe and novel surgical technique with less complications and a high success rate, excellent aesthetic and quick recovery after surgery. ELIN restores the micro‐dynamic stress at the fracture ends and promotes fracture healing, keeps intact the fracture hematoma and maintains the blood supply, accelerates healing and thus leads to faster osseous healing and better restoration of clavicle length.
Highlights
IntroductionThe clavicle is considered one of the most commonly fractured bones, and accounts for 2.6%–12% of all fracture
The clavicle is considered one of the most commonly fractured bones, and accounts for 2.6%–12% of all fracture.Middle third fractures accounts for 80%, whereas fractures of the lateral and medial third of the clavicle account for 15% and 5% of all fractures, respectively[1]
This study describes the technique of minimally invasive intramedullary fixation of midclavicular fractures with elastic locking intramedullary nail (ELIN)
Summary
The clavicle is considered one of the most commonly fractured bones, and accounts for 2.6%–12% of all fracture. Middle third fractures accounts for 80%, whereas fractures of the lateral and medial third of the clavicle account for 15% and 5% of all fractures, respectively[1]. According to the Allman classification, fractures of the clavicle are divided into three groups: (i) fractures of the middle third;. The surgical indications for mid-shaft clavicle fractures are controversial and have changed recently. Most of the clavicle fractures have been treated conservatively. There is a general agreement that un-displaced fractures should be treated non-operatively[4]. Some studies even suggest that displaced mid-shaft clavicle fractures should be treated non-operatively, and they believe that non-operative treatment yields good results without incurring the potential complications of surgery[5]
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