Antegrade flexible intramedullary nailing for fixation of displaced midshaft clavicle fractures

S.M, Dr.Shishir; Lingaraj, Dr; Zachariah, Dr.Ashish Philip; Kanagasabai, Dr. R.; Najimudeen, Syed; Gananadoss, Dr James J

doi:10.9790/0853-13422937

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…Estimated sample size considering the outcome with respect to constant score reported in the article by Shishir et al with following assumption-96.4%. 18 Percent of patients had excellent functional outcome with respect to the constant score with absolute precision of 7% and 95% confidence interval. Sample size required for study was 26.…”

Section: Sample Sizementioning

confidence: 89%

Functional and radiological outcomes of mid-shaft clavicle fracture managed by flexible intramedullary nailing

Agarwal

Belapurkar

2022

Int J Res Orthop

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Background: Clavicle fracture is a common injury accounting for 2.6-5% of all injuries. The commonest site of fracture is the midshaft. Historically clavicle fractures were managed conservatively with figure-of-eight bandage resulting in higher non-union and symptomatic malunion rates. With the advent of operative fixation of these fractures the ideal surgical technique remains elusive. Flexible intramedullary nailing stands out as a minimally invasive and effective method with excellent outcomes for fixation of these fractures.Methods: A prospective study was carried out over 18 months. A total of 26 patients met the inclusion criteria and were operated with flexible intramedullary nailing. Regular follow up was done till 14 weeks. At each postoperative visit patients were evaluated for shoulder function using constant score and DASH score. Radiographs were taken at each visit to evaluate for fracture alignment and union.Results: In this prospective study a total of 26 patients with closed midshaft clavicle fracture were managed using flexible intramedullary nail. Average time to radiological union was 7.5 weeks. Average disabilities of arm, shoulder and hand (DASH) score at 14 weeks was 13 and average constant score was 95 suggesting excellent functional outcome.Conclusions: Flexible intramedullary nailing is a simple, minimally invasive surgical technique with excellent functional outcomes for management of midshaft clavicle fractures.

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Section: Sample Sizementioning

confidence: 89%

Functional and radiological outcomes of mid-shaft clavicle fracture managed by flexible intramedullary nailing

Agarwal

Belapurkar

2022

Int J Res Orthop

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Outcomes of Displaced Midclavicular Fractures in Adults Treated With Antegrade Titanium Elastic Intramedullary Nails

Borthakur¹,

Haque²

2016

jebmh

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BACKGROUND Clavicle fractures were traditionally treated nonoperatively, but due to higher rates of delayed union, non-union, symptomatic, malunion cosmetic deformity and other complications. There is an increasing trend for operative management. Plating and intramedullary nailing are the most popular surgical options. The use of intramedullary titanium nails requires smaller incisions, avoidance of significant soft tissue stripping, minimal complications, and early return to work. The aim of the study was to evaluate the clinical outcome of displaced midclavicular fractures (DMCFs) in adults treated with titanium elastic nails (TENs). MATERIAL AND METHODS Prospective study was conducted between 2009 and 2013 in which 34 patients (26 males and 8 females) with mean age of 39.1 years with OTA type B DMCFs underwent surgical fixation with TENs. Evaluation done by Constant and DASH scores at 6, 12 weeks, 3, 6, and 12 months to determine outcomes. RESULTS Closed reduction was possible in 20 patients (58.82%). All the patients achieved clinical and radiological union at 9.38±1.44 weeks. The final Constant and DASH scores were 93.37±3.06 and 5.63±2.66. There were no major complications, only minor complications of shortening >0.5 cm (n=3, 8.82%), superficial infection (n=3, 8.82%) and medial TEN protrusion (n=7, 20.58%). CONCLUSION The intramedullary fixation of DMCFs with TENs is a minimally invasive, safe, and effective procedure, which provides good functional outcome, high union rate, early pain relief, return to work, and better cosmetic results with minimal complications in indicated cases. LEVEL OF EVIDENCE Level III.

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Can Titanium elastic nails deliver a knockout punch against precontoured locking plates in handling displaced middle third clavicle fractures?

Shaik¹,

Paka

Pilaka³

et al. 2022

Journal of Orthopaedic Diseases and Traumatology

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Background: Plating is the gold standard for displaced middle third clavicle fractures, which holds true at least for comminuted fractures with a fair share of complications. For displaced fractures without comminution, intramedullary titanium elastic nailing system is an emerging option which claims similar success rates with fewer complications. There is a deficit in data pertaining to prospective trials supporting such claims which has propelled us to carry out this study. This study aims to compare the functional outcome and complication rates between precontoured locking plates and titanium elastic nails for displaced clavicle fractures. Materials and Methods: A prospective cohort study carried out on 56 patients with displaced clavicle fractures without comminution treated either by nailing (with open reduction through minimal incision at fracture site) or plating, and the results pertaining to their functional outcome and complication rates were compared. Results: Nottingham clavicle score and Constant Murley score were calculated at 6, 12, and 24 months along with comparison of complication rates. Conclusion: The functional outcome scores recorded significant differences at 6- and 12-month periods between the groups, which minimized at 24 months. Complication rates were significantly different between the groups. These results of functional outcome and complication rates point toward titanium nailing as an attractive alternative to plating for a comminuted displaced middle third clavicle fractures.

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Antegrade flexible intramedullary nailing for fixation of displaced midshaft clavicle fractures

Cited by 3 publications

References 26 publications

Functional and radiological outcomes of mid-shaft clavicle fracture managed by flexible intramedullary nailing

Functional and radiological outcomes of mid-shaft clavicle fracture managed by flexible intramedullary nailing

Outcomes of Displaced Midclavicular Fractures in Adults Treated With Antegrade Titanium Elastic Intramedullary Nails

Can Titanium elastic nails deliver a knockout punch against precontoured locking plates in handling displaced middle third clavicle fractures?

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