ABSTRACT
Objective To evaluate the clinical effect of minimally invasive treatment of clavicle fracture with a hollow screw.Methods Data of 65 patients,who had undergone minimally invasive treatment with a hollow screw for clavicle fracture from April 2009 to October 2010,were retrospectively analyzed.There were 41 males and 24 females,aged from 19 to 67 years (average,35.8 years).According to the Craig's classification,there were 29 of group I and 36 of group Ⅱ-Ⅱ.A 4-5 cm transverse incision was made to expose the clavicle fracture.A guide pin was inserted into the marrow cavity,and then moved towards the acromion,after the fracture was reduced the pin was moved back to the proximal clavicle,finally a hollow screw was implanted to fix the fracture.The Neer score was used to evaluate the function of the shoulder.Radiographs were taken to observe the condition of the fracture union.The operative duration,intra-operative blood loss,fracture healing time,Neer score,and complications were compared with those of 65 patients with clavicle fracture who were treated by the same surgeons with plates.Results The incision length was 4-5 cm in hollow screw group and 10-11 cm in plate group.X-rays showed bone union was achieved in both groups,and the average bone healing time was 13.2±6.9 weeks in hollow screw group and 16.3±8.7 weeks in plate group.All patients were followed up for 6 to 20 months (average,10.6 months).The average Neer score was 96.6±3.4 in hollow screw group and 94.2±5.8 in plate group.There was no infection,local skin necrosis and fracture nonunion in both groups.In hollow screw group,screw loosing occurred in 5,and fracture displacement in 3,fortunately,the fracture healed by controlling activities.There was a significant difference in fracture healing time between two groups.However,no significant difference was observed between two groups in Neer score.Conclusion Minimally invasive treatment of clavicle fracture with a hollow screw has several advantages,such as mini-invasion,short bone healing time,good clinical outcomes,and lower expense.