Authors : Mohammed Aquib Shakeel, Sreenivasa N
DOI : 10.18231/j.ijos.2021.023
Volume : 7
Issue : 2
Year : 2021
Page No : 140-148
Introduction: Midclavicular fractures accounts for about 76% of all clavicular fractures and are common clinically. Recent studies have revealed a previously unrecognized incidence of non-union and malunion after conservative treatment of more severe midclavicular fractures. Our aim was to evaluate the clinical outcomes of midclavicular fractures treated with titanium elastic nails.
Methods: A hospital based prospective study conducted between April 2018 to April 2020 at VIMS bellary. 30 patients with displaced midshaft clavicle fracture between 18 to 50 years were assessed clinically and confirmed radiologically were operated with intramedullary nailing with titanium elastic nail (TEN). Mean operative time, postoperative complications, duration of union was recorded. The outcomes were evaluated with radiographic assessment and the disabilities of the arm, shoulder, and hand (DASH) score.
Results: Closed operation with TENS was undertaken in 28 cases, and mini open technique was performed in 2 cases. Satisfactory reduction was achieved in all patients, who were followed up for a mean of 10 months. The mean union time was 11.2 weeks. TENS led to a significantly shorter time to union, especially for simple fractures. In TENS group, all patients got fracture union, of which 4 cases had medial skin irritation due to implant prominence. No severe complication occurred in any patient. TENS removal done at 10 months after surgery, no re-fracture and non union was found in any our patient. Average DASH score
was 3.0023.
Conclusion: Intramedullary fixation with TENS might be a effective and safe treatment for displaced midshaft clavicular fractures with few complications, satisfactory clinical therapeutic effects, good functional recovery and cosmetic appearance.
Keyowords: Displaced midshaft clavicular fractures; Minimally invasive treatment; Titanium elastic nail; DASH score.