A PROSPECTIVE STUDY OF DISPLACED MID-SHAFT CLAVICLE FRACTURES TREATED WITH INTRAMEDULLARY TITANIUM ELASTIC NAIL SYSTEMS

Authors

  • ANANTH A Department of Orthopaedics, Kurnool Medical College, Kurnool, Andhra Pradesh, India. https://orcid.org/0009-0005-3133-3478
  • RAVI PRAKASH Department of Orthopaedics, Kurnool Medical College, Kurnool, Andhra Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i7.51040

Keywords:

Mid-shaft clavicle fracture, Titanium elastic nail systems, CONSTANT and MURLEY score

Abstract

Objective: Clavicle fractures are common injuries accounting for 2.6 to 4.0% of all fractures. It has been previously published that mid-third fractures constitute approximately 80% of all clavicle fractures. The two predominantly used procedures that are the current trend in the operative management of midshaft clavicle fractures are open reduction & plating; and intramedullary nailing through minimal access. This study evaluated the efficacy of the Titanium Elastic Nail system (TENS), a minimally invasive technique, in treating midshaft clavicle fractures.

Methods: From December 2022 to January 2024 with twenty-four patients who had plain radiographs showing a midshaft clavicle fracture, this study was conducted in our hospital which is a tertiary care facility. Patients were reviewed at 2 and 6 weeks,3 and 6 months after surgery. Nails were removed after 6 months of surgery.

Results: The average operative time duration was 37.1 minutes (Range: 25 - 60 minutes). 18 of the 24 patients had closed reduction while 6 patients (25%) patients required open reduction of their fracture. All the patients achieved clinical union at an average of 5.3 weeks (Range: 4-6 weeks) and radiological union at an average of 10.47 weeks (Range: 6 - 12 weeks). The patients were followed up postoperatively and CONSTANT and MURLEY scores were calculated at 6 weeks with an Excellent CONSTANT score in 20 patients (83.3%).

Conclusion: Besides being early mobilization, minimally invasive, and requiring less time during surgery, TENS fixation offers superior cosmetic results. For this reason, the preferred course of treatment for displaced midshaft clavicle fractures is titanium elastic nails.

Downloads

Download data is not yet available.

References

Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res. 1994;300:127-32.

Park JS, Ko SH, Hong TH, Ryu DJ, Kwon DG, Kim MK, et al. Plate fixation versus titanium elastic nailing in mid-shaft clavicle fractures based on fracture classifications. J Orthop Surg (Hong Kong). 2020;28(3):1-11. doi: 10.1177/2309499020972204

Jubel A, Andermahr J, Schiffer G, Tsironis K, Rehm KE. Elastic stable intramedullary nailing of midclavicular fractures with a titanium nail. Clin Orthop Relat Res. 2003;408:279-85. doi: 10.1097/00003086- 200303000-00037

Kadakia AP, Rambani R, Qamar F, McCoy S, Koch L, Venkateswaran B. Titanium elastic stable intramedullary nailing of displaced midshaft clavicle fractures: A review of 38 cases. Int J Shoulder Surg. 2012;6(3):82-5. doi: 10.4103/0973-6042.102557

Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD; Evidence- Based Orthopaedic Trauma Working Group. Treatment of acute midshaft clavicle fractures: Systematic review of 2144 fractures: On behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005;19(7):504-7. doi: 10.1097/01.bot.0000172287.44278.ef

Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997;79(4):537-9. doi: 10.1302/0301-620x.79b4.7529

Golish SR, Oliviero JA, Francke EI, Miller MD. A biomechanical study of plate versus intramedullary devices for midshaft clavicle fixation. J Orthop Surg Res. 2008 Jul 16;3:28. doi: 10.1186/1749-799X-3-28

Gadegone WM, Lokhande V. Screw intramedullary elastic nail fixation in midshaft clavicle fractures: A clinical outcome in 36 patients. Indian J Orthop. 2018;52(3):322-7. doi: 10.4103/ortho.IJOrtho_381_16

McKee M. Elastic stable intramedullary nailing was effective in displaced midshaft clavicular fractures. J Bone Joint Surg Am. 2009;91(11):2746. doi: 10.2106/JBJS.9111.ebo443

Abraham VT, Marimuthu C. A study on the outcome of displaced midshaft non-comminuted clavicle fractures treated with anatomical locking plate versus titanium elastic nail. J Orthop Trauma Rehabil. 2020:1-5. doi: 10.1177/2210491720975189

Saraf H, Kasture S. Treatment of displaced mid-clavicle fractures by closed titanium elastic nail. Surg Sci. 2016;7:49-53. doi: 10.4236/ ss.2016.72006

Published

07-07-2024

How to Cite

A, A., and R. PRAKASH. “A PROSPECTIVE STUDY OF DISPLACED MID-SHAFT CLAVICLE FRACTURES TREATED WITH INTRAMEDULLARY TITANIUM ELASTIC NAIL SYSTEMS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 7, July 2024, pp. 30-32, doi:10.22159/ajpcr.2024v17i7.51040.

Issue

Section

Original Article(s)