Abstract
Purpose of study:
To assess the effectiveness of a novel locked intra-medullary device in the treatment of acute clavicle shaft fractures.
Description of methods:
Patients admitted with midshaft clavicle fractures were assessed for inclusion in the study. Inclusion criteria were mid shaft clavicle fractures with 100% displacement; more than 1, 5 cm of shortening or containing a displaced butterfly segment. Fractures were assessed for suitability to intra-medullary fixation (fracture distance from the medial and lateral end of the clavicle, medullary diameter and fracture type). 35 patients were treated operatively using the device by the author. Post-op, patients were kept in a master sling for a period of 6 weeks and followed up for a period of at least 3 months. Fracture reduction, fracture progression to union, scar size, Dash score, Constant Shoulder score, patient satisfaction and complications were assessed at follow-up by the surgeon, a radiologist and an occupational therapist.
Summary of results:
35 patients, 26 males and 9 females with a mean age of 29 were included in the study. All fractures treated achieved union within expected limits with no operative complications. Excellent cosmetic results were achieved in 34 patients with a high level of patient satisfaction reported. 3 patients developed post-operative complications – 2 nail failures and 1 hardware sepsis. All 3 complications were due to inferior implant placement due to initial surgeon inexperience with the device and patient non-compliance with the post-operative regime.
Conclusion:
Locked intra-medullary fixation of clavicle shaft fractures that fit the criteria for operative fixation was found to be a reliable, safe method of achieving fracture reduction and fracture union in 35 patients treated. The operation is moderately demanding with a short learning curve.
