Efficacy of titanium elastic intramedullary nail for treatment of clavicular shaft fractures in young and adolescent patients / 中华全科医师杂志

ABSTRACT

From January 2012 to January 2017,98 patients with clavicular fractures were treated with titanium elastic intramedullary nail(TEN),including 58 males and 40 females with an average age of 14.5 years (11-18 years).The mean time from injury to surgery was 4.2 d (2-7 d).Sixty nine cases were treated by closed reduction and 29 cases by 2-3 cm incision.Constant function scores and disability of the arm shoulder and hand (DASH) scores were compared before surgery and 4 wks after surgery;Neer function scores at 3 months after surgery were compared between the injured side and unaffected side.All patients were reexamined at a mean follow-up of 6.5 months (3-8 months),and fracture union was determined by X-ray.The results showed that the bony union was ranged from 8-16 weeks with an average of 12.4 weeks.There were 4 cases with soft tissue irritation;no cases of infection,TEN broken,delayed healing were observed.The Constant score rose from 41.7±4.8 before operation to 92.6±3.2 at 4 weeks after operation (t=16.67,P＜0.01);the DASH score rose from 3.8±2.1 before operation to 15.8±1.8 at 4 weeks after operation (t=8.59,P＜0.01).There was no significant difference in Neer score at 3 months after treatment between unaffected side and injured side (98.56±2.41 vs.97.45±3.32,t=1.64,P＞0.05).The TEN was removed after showing bone healing on X-ray film.The study indicates that using TEN has advantages of less invasiveness,reliable fixation and rapid functional improvement of shoulder for treatment of clavicular fracture in young and adolescent patients.