Abstract:

BACKGROUND: The internal fixation methods of mid-shaft clavicle fracture mainly include intramedullary fixation and extramedullary fixation. The different internal fixation methods result in significant different influences on patient trauma, treatment cost, and the final clinical effects. Therefore, it is very important to choose reasonable internal fixation methods for curing mid-shaft clavicle fracture.
OBJECTIVE: To compare the clinical effects of internal fixation for mid-shaft clavicle fracture using titanium elastic nail (TEN) or reconstruction plate. 
METHODS: A total of 42 cases with middle 1/3 of clavicular fracture were tre ated, including19 using TEN and 23 using reconstruction plate. Operation time, hospitalization, amounts of bleeding, length of skin incision, healing time of fracture, complications and shoulder function recovery after surgery were compared between these two groups.  
RESULTS AND CONCLUSION: The TEN group had better results compared with reconstruction plate group in operation time, hospitalization, the amount of bleeding, length of skin incision, healing time of fracture (P < 0.05). There was no significant difference between the two groups in shoulder function recovery (P < 0.05). Occurrence of complications as follow: In TEN group, nail quit in 1 case, nail tail irritation in 1 case (no skin ulceration), no fracture nonunion and fracture stump rotation were found; In Reconstruction group, nail loose in 1 case, no infection, plate broken, fracture nonunion were found. No infections were found in all cases. Both methods are good choices for fixation of mid-shaft clavicle fracture. But TEN would be the best choice in terms of tissue trauma, treatment time, function recovery and expense. However, reconstruction plate fixation is certainly a better choice in complicate fracture.