Abstract
Objective To evaluate and compare the treatment outcomes of two minimally invasive internal fixation methods for midshaft clavicular fractures. Methods A retrospective study was conducted of 62 patients with midshaft clavicular fractures treated between January 2010 and August 2014. Among them 34 patients were treated with minimally invasive percutaneous locking reconstruction plate fixation (plate group), while 28 patients were treated with percutaneous elastic intramedullary nail fixation (nail group). Intraoperative parameters, pain score at postoperative day 3, bone union time, clinical outcomes and complications were compared between the two groups. Results There were no statistically significant differences in intraoperative fluoroscopy time, postoperative pain score and bone union time for type A fractures between the two groups. Surgery time was significantly shorter in the nail group. Bone union time for type B fractures was significantly shorter in the plate group. DASH score or Constant-Murley score for type A fractures were not different between the two groups at 6 months, but significantly higher in the plate group for type B fractures. At 12 months no significant differences in DASH or Constant-Murley scores were noted between the two groups for either type A or type B fractures. A higher rate of skin irritation was seen in the nail group. There were no significant differences between the two groups with regard to infection, loosening or migration of internal fixation and re-fracture. Conclusion Both percutaneous locking reconstruction plate fixation and percutaneous elastic intramedullary nail fixation are effective minimally invasive methods for treating midshaft clavicular fractures. For type B comminuted midshaft clavicular fractures, percutaneous locking reconstruction plate fixation is a better option due to its shorter bone union time, better function scores and lower complications. Key words: Clavicle; Fracture fixation, internal; Locking reconstruction plate; Elastic stable intramedullary nail
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