Elastic Stable Intramedullary Nailing Versus Plate Osteosynthesis of Mid-Clavicular Fractures-A Comparative Study

ABSTRACT

The biomechanical characteristics of midshaft clavicular fractures treated with titanium elastic nail is not well studied. This study aimed to present a analysis of titanium elastic nail fixation and reconstruction plate fixation for midshaft clavicular fractures. Methods: Forty-four patients between 18 and 65 years of age were included in this study. They were randomized in two groups to be treated with either elastic intramedullary nail (ESIN) or plate. Clinical and radiological assessments were performed at regular intervals. Outcomes and complications of both groups over 2 years of follow-up time were compared. Results: Length of incision, operation time, blood loss and duration of hospital stay were significantly less for the ESIN group. American Shoulder and Elbow Surgeons (ASES) and Constant Shoulder scores were significantly higher (p\0.05) in the plating group than the EIN group for the first 2 months but there was no significant difference found between the two groups regarding functional and radiological outcome at the 2-year follow-up. Conclusion: ESIN is minimally invasive surgical technique with a lower complication rate, faster return to daily activities, excellent cosmetic and comparable functional results, and can be used as an equally effective alternative to plate fixation in displaced midshaft clavicle fractures.