Comparative study on surgical fixation of displaced midshaft clavicle fractures by elastic intramedullary nailing versus precontoured plating

Abstract

Background: Displacement occurs in about 73 % of all midshaft clavicle fractures and higher rates of delayed union, nonunion, shoulder pain, and shoulder weakness and residual pain are seen with non-operative treatment. The present study was conducted to compare outcomes and complications of titanium elastic intramedullary nailing and anatomically precontoured plating in displaced midshaft clavicular fractures. Methods: The present study was prospective in nature conducted upon patients with closed clavicular mid one-third fractures with age more than 16 years. All patients were divided in two groups and treated by titanium elastic intramedullary nailing and anatomically precontoured plating. They were assessed clinico-radiologically at 4,8 12 and 24 weeks. The functional outcome was assessed by Constant Murley score at 24 weeks. Results: Mean age among group 1 was 32.4±9.1 years and that among group 2 was 27.8±10.3 years. 81.3% of the study subjects in group 1 and 87.5% in group 2 were males. Most common mode of injury was RTA (62.5% in group 1 and 68.8% in group 2). Higher CMS score was seen in TENS group as compared to plating group. The difference among two groups was statistically significant (p<0.05). Conclusions: In closed mid-shaft clavicle fractures, TENS nailing is superior to clavicular plating in terms of better functional outcome, faster union, fewer complication.