Treatment progress in minimally invasive intramedullary fixation for midshaft clavicle fracture

Abstract

Nowadays, more and more studies on mini-invasive treatment of clavicle fractures have been reported. Firstly, based on the newly published literature about intramedullary fixation for midshaft clavicle fractures, this paper reviews its indications and advantages. Next, the design characteristics, surgical procedures, therapeutic effects and latest treatment advances concerning the intramedullary implants are systemically demonstrated and compared. Intramedullary fixation can be used in most midshaft clavicle fractures except those with neurovascular lesions or with comminuted segments, or obsolete ones. The commonly used intramedullary implants include Kirschner wires, cannulated screws, titanium elastic nails, threaded nails, and second-generation intramedullary nails. Intramedullary fixation has potential advantages of a smaller incision, fewer complications, a lower refracture risk and faster bone healing but also limitations in strength and stability. However, more and more intramedullary implants, from cannulated screws to second-generation intramedullary nails, have been used in clinic, leading to fine therapeutic effects. New products are being developed to overcome the previous shortcomings. Key words: Midshaft clavicle fracture; Fracture fixation, intramedullary; Surgical operation, minimallynvasive; Latest advances