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

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.