ABSTRACT
BACKGROUND: For the treatment of middle clavicle fractures, elastic intramedullary nailing has gradually gained everyone's approval because of its small incision and short operation time. Locking plate fixation is currently the main surgical treatment. At present, there are a few comparative studies on the results of the two surgical treatments, but the results are still controversial. In particular, there is a lack of comparative studies on long-term efficacy and complications. OBJECTIVE: To compare clinical results and complications of locking plate and elastic intramedullary nailing for middle clavicular fracture. METHODS: A retrospective analysis of 85 patients with middle clavicular fractures who were hospitalized at the Army General Hospital of Second Medical College of Southern Medical University from June 2014 to June 2015 undergoing surgeries was performed. They were divided into two groups randomly: locking plate group (n=62) and elastic intramedullary nailing group (n=23). The incision length, operation time, blood loss and time of hospital staying were compared between the two groups. Regular follow-up, radiography assessment and postoperative complications and shoulder function score were measured. RESULTS AND CONCLUSION: (1) Incision length, operation time, blood loss and time of hospital staying were significantly better in the elastic intramedullary nailing group than in the locking plate group (P < 0.05). (2) The complications of the elastic intramedullary nailing group were significantly lower than that of the locking plate group (P < 0.05). The main complications of locking plate group were superficial wound infection, hypesthesia in the local incision and implant protuberance. Only two patients in the intramedullary nailing group experienced complications. (3) The healing rate of elastic intramedullary nailing group was higher than that of the locking plate group, which was not statistically significant (P > 0.05). (4) The DASH scores and the Constant-Murley scores of the two groups after operation were not statistically significant (P > 0.05). (5) The elastic intramedullary nailing and locking plate are both effective methods for the treatment of middle clavicular fracture. Incision length, operation time, blood loss and average length of hospital stay have obvious advantages; the incidence of complications is low; and recovery is fast in the elastic intramedullary nailing group. However, elastic nail may stimulate the local skin, causing some impact for the patients' daily life.