Operative Fixation of Displaced Midclavicular Fractures in Adult by Titanium Elastic Nailing System

Abstract

Introduction and aim: Clavicular fractures are very common, and it usually treated conservatively. However, recent shift to surgical intervention had been observed. The guidelines seem to be in its road to change. The aim of this work is to asses clinical and radiological results of surgical fixation of midshaft clavicle fractures by Titanium Elastic Nailing System.
 Methodology: Fifteen patients with mid-shaft (middle third) displaced fractures of the clavicle were included. All were assessed in systematic manner (history, examination and investigations). Then, eligible patients provided an informed consent and underwent surgical treatment according to study protocol. All were followed up for 6 months and their outcome was ranged according to Constant and Murley Score.
 Results: Ten patients (66.7%) had excellent, 3 patients (20%) had good, one patient (6.7%) had fair, and one patient (6.7%) had poor outcome. Pain was absent or mild in the majority of patients (93.3%). 86.7% of patients return to full work, and all had unaffected sleep. Union was achieved in 14 patients (93.3%). One patient had an infection, two had medial end skin irritation and one had hypertrophic non-union. Younger age and absence of any associated medical disease were associated with excellent outcome.
 Conclusion: Titanium Elastic Nailing could be considered as a reasonable alternative approach to the management of displaced mid-shaft clavicular fractures, as it is associated with excellent outcome, low pain, and early return to normal daily activities.