Abstract:

BACKGROUND: In recent years, fixation in bone marrow, such as Kirschner wire, has got satisfactory effects in most of patients with mid-shaft fracture of clavicle. However, there are still some complications in part of patients. Titanium elastic nail (TEN) is a common method for treating child long bone fractures. 
OBJECTIVE: To compare TEN and Kirschner wire in treat the mid-shaft clavicle fractures, so as to provide clinical evidences for the improvement of treatment of mid-shaft clavicle fractures.
METHODS: A total of 46 cases with middle 1/3 of clavicular fracture were underwent surgical treatment, 15 cases using TEN, 31 cases using Kirschner wire. Operation time, hospitalization, healing time of fracture, complications and shoulder function recovery at 3 weeks after surgery were compared.
RESULTS AND CONCLUSION: Compared with Kirschner wire group, TEN group had better results in healing time of fractur (P < 0.05); patients in the TEN group could perform early active functional exercises, and the range of motion of affected shoulder was almost the same compared with normal side at 3 weeks after surgery, while Kirschner wire group need to caging the shoulder over 4 weeks and forbid the early active functional exercises. Occurrence of complications: 1 case with nail quit 1 case with nail tail irritation without skin ulceration, no fracture nonunion and fracture stump rotation were found in the TEN group. 7 cases with wire loose, 6 cases with wire tail irritations, 4 cases with wire tail inflammatory sinus tract, 2 cases with fracture displaced or nonunion (changed for reconstruction plate) in the Kirschner wire group. Compared with Kirschner wire, TEN have advantages of less healing time, high recovery rate, less complications, early functional exercises after surgery. Therefore, TEN is a better choice for patients with mid-shaft clavicle fractures.