Results of midshaft clavicle fractures treated with expandable, elastic and locking intramedullary nails.

Abstract

The aim of the study was to present the results of osteosynthesis with elastic expandable intramedullary nail for clavicle fractures. The study included 17 patients (11 males, 6 females; mean age 36.4 years, range: 21 to 54 years) who underwent surgery for a displaced clavicle fracture and had a shortening of more than 2 cm. The Constant Score and DASH (Disabilities of The Arm, Shoulder and Hand) scoring were used to determine the functional status of the patients. Mean operation time was 30.4 (range: 25 to 42) minutes and mean follow-up period was 10.3 (range: 8 to 19) months. Mean union time was 15.8 (range: 9 to 20) weeks. A superficial infection was treated with wound debridement and antibiotherapy in one patient. No patient suffered from neurovascular compromise, deep infection or implant irritation. Implant fracture developed at 2 months after surgery in one patient treated for Type B1 clavicle fracture and healed without any other intervention. There was no statistically significant shortening (p>0.05). In the final follow-up, the mean Constant Score was 94.3 (range: 86 to 97), and mean DASH score was 11.8 (range: 7.3 to 17.4). Expandable elastic locking intramedullary nail appears to provide minimal complication and high success rate for the surgical treatment of non-comminuted displaced clavicle shaft fractures. Additional studies with large series are necessary for further investigation.