Intramedullary Screw Fixation of Midshaft Clavicle Fractures

Abstract

Clavicle fractures are common injuries historically treated nonoperatively. As the recent literature has revealed potential shortcomings with nonoperative treatment when certain fracture characteristics are observed, operative fixation has become more widespread. Both intramedullary fixation and plate fixation are commonly used when operative fixation is elected. Intramedullary fixation has the potential advantages of a smaller incision with less soft tissue dissection and a less prominent implant. Various methods of intramedullary fixation have been described over the past 2 decades to include the Rockwood and Hagie pins, Kirschner wires, titanium elastic nails, and, more recently, clavicle-specific implants such as the Dual-Trak clavicle screw and the Sonoma clavicle pin. No single implant has been proven superior and some come at considerable cost. We describe our technique for intramedullary fixation of midshaft clavicle fractures utilizing a single partially threaded, cannulated 6.5mm screw.