Efficacy of Intramedullary Bridge Fixation for Midshaft Clavicle Fractures: A Retrospective Analysis of a Novel Technique

Abstract

Objective: This study aimed to explore the efficacy of a novel intramedullary fixation technique using the ortho-bridge system (OBS) in midshaft clavicle fractures. Methods: A total of 63 patients were included in this study, of which 35 were treated with plate internal fixation (LP group) and 28 with OBS intramedullary fixation (OBS group). Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of internal fixation, visual analog scale (VAS) for shoulder pain, Constant Shoulder Score and complication occurrence were compared between the two groups. Results: In preoperative general data, such as sex, age and fracture types were not significantly different between the two groups (P > 0.05). However, the OBSgroup showed better outcomes than the LP group in terms of surgical time, intraoperative blood loss and total incision length (P< 0.05). Additionally, the OBS group exhibited significantly shorter fracture healing time and internal fixation removal time than the LPgroup (P < 0.05). VAS scores at postoperative day 1, week 1, month 1 and month 3 were lower in the OBS group than in the LPgroup (P < 0.05).Furthermore, the OBS group had higher Constant Shoulder Scores at 1, 3, and 6 months than the LPgroup (P < 0.05), with no significant difference at 1 year postoperatively (P > 0.05). There was no scarring in the surgical incision in the OBS group, while 6 cases of scarring in the surgical incision occurred in the LP group. Lastly, complication incidence in the OBS group was lower than that in the LPgroup. Conclusion: The study revealed that compared to locking plate internal fixation for midshaft clavicle fractures, OBS intramedullary fixation presents the advantages of less trauma, faster recovery, better efficacy and better aesthetic outcomes and comfort. Therefore, this technique may have potential clinical application as a novel treatment for midshaft clavicle fractures.