Indian Journal of Orthopaedics Surgery


Evaluation the outcomes of flexible intramedullary nailing fixation of displaced midshaft clavicle fractures


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Author Details: Hemant Kumar, Ravinder K. Banga, RS Boparai, Jaspal Singh

Volume : 3

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 197

Article End Page : 201


Abstract

Introduction: Fracture of the clavicle is common in occurrence with incidence of approximately 5% of all fractures seen in hospital emergency. These fractures are generally managed conservatively. Now days, titanium elastic nails are emerging as a minimally invasive treatment for displaced mid-clavicular fractures, which may be an alternative to plate fixation or even non-operative treatment.
Objective: The aim of this study is to assess the cosmetic outcome (malunion, asymmetry, scar formation), rate of bone healing and alignment of the clavicle (<300 or >300) related to the flexible intramedullary nailing of midshaft fracture clavicle.
Methods: Between June 2012 to June 2014 in GMC & Hospital Amritsar, 50 patients with displaced, non-comminuted fracture of midshaft clavicle of either side underwent flexible intramedullary nailing with titanium elastic nail. Implant removal was performed in 90% cases after the fracture united completely.
Results: In this study, all fractures were united. Mean duration of radiological union was 10.3 weeks ranging from 6 to 20 weeks. Mean DASH score after 6 months of follow up was 7.7 ranging from 0.8 to 44.2.Mean constant self evaluated score was 80.2 ranging from minimum 43 to maximum 98 after 6 months of follow up.
Conclusion: Flexible intramedullary nailing is a minimally invasive technique for stabilization of displaced midshaft clavicle fractures and it is a simple procedure with excellent functional outcome in terms of quick return to activities and a high patient satisfaction rate with very good cosmetic outcome.

Keywords:
Intramedullary clavicle nailing, Middle 1/3rd clavicle fractures, Titanium elastic nailing System (TENS)