Minimally invasive intramedullary nailing of clavicular fractures by a new titanium elastic nail

Objectives: The aim of this study was to evaluate clinical results of a new design titanium elastic nail(TEN) for displaced midshaft clavicular fractures.Patients and methods: Between February 2012 and December 2013, a total 36 patients with displacedmidshaft clavicular fractures were treated with intramedullary nailing stabilization with our newdesign TEN. Blood loss, mean times of operation, postoperative complications, hospital stays and timeto bone union was recorded. The outcomes were evaluated with radiographic assessment, visualanalog scale (VAS) score, the Constant-Murley, and the disabilities of the arm, shoulder, and hand(DASH) scores.Results: The mean blood loss was 50.278± 10.753 ml, while the mean operation, hospital stay and boneunion times were 46.417± 9.232 min, 10.056 ± 2.672 days and 11.583 ± 2.729 weeks, respectively. Afterremoval of the TENs at a mean of 10.2 months (range, 8-13 months) after surgery, no re-fracture andnonunion was found in any patient. Two cases of shoulder back stabbing pain were spontaneouslyresolved later. The mean fracture healing time was 12 weeks. The VAS score and motion ranges ofshoulder joint were signiŞcantly improved postoperatively (P < 0.001). The shoulder function recoveryshowed the excellent results with the mean Constant-Murley score of 93.389± 2.749 and DASH scores of2.528± 1.567.Conclusion: Our new TEN design used in intramedullaryŞxation might be a safe and effective techniquefor treatment of displaced midshaft clavicular fractures.Level of evidence: Level IV, therapeutic study.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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