Die Versorgung der Klavikulafraktur mit der elastischen Markraumschienung - Freiburger Erfahrungen

Abstract

Despite of the fact that conservative treatment of the shaft fracture of the clavicle is still the treatment of choice of this injury, the introduction of new techniques of osteosynthesis give us the possibility to define new aspects of indication of surgical treatment of this fracture. First experiences with the new technique of intramedullary stabilization of clavicle fractures shows encouraging results. Between 7/2001 and 6/2004 in our department 67 patients with a shaft fracture of the clavicle were treated with an intramedullary stabilization with a titanium elastic nail (TEN). 3 of this fractures were open fractures. The main cause of injury were bycicle accidents. In 31 cases closed reduction was possible, in 36 cases open reduction had to be performed. Average duration from accident to operation was 7 days in the group of closed reduction and 13 days in the group of open reduction. As complications we saw migration of the TEN and in one case a lesion of the arm plexus caused by a haematoma. As conclusion the stabilization of shaft fractures of the clavicle with the intramedullary TEN became the new standard method for operative treatment of this injury in our department. The minimal invasive approach, easy implant removal, the lack of re-fractures after implant removal and low rate of complications demonstrate the technical benefit of this new technique. Additional a fast mobilization is possible after successful operation.