Minimally invasive fixation of midclavicular fractures with threaded elastic intramedullary nails.

Abstract

Intramedullary fixation of midclavicular fractures has been described as a minimally invasive operation with few complications. The purpose of this study was to assess the effectiveness of the threaded elastic intramedullary nail (TEIN, made in Kang Li Min Medical Devices Co. Ltd., Tianjin, China) in the treatment of midclavicular fractures. Between 2010 and 2013, 45 patients with midclavicular fractures, who received closed reduction and intramedullary fixation, were treated with the TEIN in our department. Clinical outcomes were evaluated after a follow-up of 14 (3-42) months. We used the Constant score and the disabilities of the arm, shoulder and hand (DASH) scale to determine the outcomes. The mean time of the operation was 22.4 (13-40) min. The rate of the closed reduction was 64 %. The mean time of the follow-up was 14 (3-42) months. With regard to complications, there was no occurrence of neurovascular impairment, pulmonary injuries, infection, shortening, refracture or nonunion. All of the patients displayed excellent shoulder function, with a mean Constant shoulder score of 96.5 (64-100) and a mean DASH score of 1.4 (range 0-100) at the latest follow-up. Closed reduction and intramedullary fixation of midclavicular fractures with the TEIN present a safe and minimally invasive surgical technique, achieving excellent aesthetic and early recovery after surgery. Treatment Study, Level II.