Arthroscopic fixation of the clavicle shaft fracture

Abstract

This article describes an arthroscopic technique for the fixation of clavicle shaft fractures. A viewing portal is made 2 cm anterior to the fracture site, and a working portal is made 2 cm lateral to the fracture site. The guide wire for a 4.0-mm cannulated screw is inserted through the fracture site to the medial fracture fragment under arthroscopic guidance. Through the medial fragment, the guide wire is delivered through the skin anteriorly. The fracture is reduced, and then, the guide wire is drilled back across the fracture site to the lateral fracture fragment. After confirming the reduction under arthroscopy, the appropriately sized cannulated screw is inserted after reaming. This arthroscopic technique would be useful for the precise reduction and minimal invasive fixation of clavicle shaft fractures. Preliminary results are encouraging, and further studies with long-term follow-up are needed to determine the precise indications and limitations of the procedure.

Biomechanical comparison between solid and cannulated intramedullary devices for midshaft clavicle fixation

“…Surgical implants of midshaft clavicle fixation can be summarized into two types: plates and intramedullary fixation. To reduce the incidence of wound infection and fracture nonunion, a closed or minimally invasive method using intramedullary fixation with cannulated screws had been proposed [6–9]. However, there are no mechanical studies on the use of cannulated screws in the fixation of midshaft clavicle fractures.…”