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European Journal of Trauma and Emergency Surgery

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01-04-2022 | Clavicle Fracture | Original Article

Lateral approach for intramedullary nailing of displaced midshaft clavicle fractures; a retrospective cohort study

Authors: Nina Kabelitz, Method Kabelitz, Herman Frima, Alexandra Rehm, Christoph Sommer, Christian Michelitsch

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

Abstract

Purpose

Midshaft clavicle fractures represent about 4% of all fractures in the emergency department. Non-operative treatment of displaced midshaft clavicle fractures (DMCF) can result in a relatively high non-union rate. Several operative techniques, including intramedullary fixation (IMF) using elastic stable intramedullary nailing (ESIN), have therefore been established. IMF through the medial approach is less suitable for fractures of the lateral diaphysis. IMF of DMCF of the lateral diaphysis through a lateral approach can be an alternative approach for these fractures. The aim of this study is to describe the technique of IMF from the lateral side and to present the functional outcome and complications.

Methods

A retrospective cohort study was performed. All patients with a traumatic DMCF treated with IMF using ESIN through a lateral approach between 2014 and 2019 were included. Endpoints were the functional outcome (QuickDASH, Subjective Shoulder Value (SSV)), pain (numeric rating scale (NRS)), daily impairment (activities of daily living (ADL)), complications and implant removal.

Results

Forty out of 43 patients were available for follow-up. Mean follow-up was 37 months. Mean age was 24 years (range 13–70). The median QuickDASH score was 0 (IQR 0.0–0.0) and the median SSV was 100 (95–100). The median ADL score was 1 (1–4) and the median NRS was 0 (0–0). No non-union occurred. Implant related irritation occurred in 11 patients (27.5%). Implants were removed in a total of 38 (95%) patients; in 10 cases due to irritation, in 28 cases routinely or on patient’s request.

Conclusion

IMF of DMCF of the lateral diaphysis through a lateral approach leads to excellent functional results and seems to be a suitable option for internal fixation. However, as with IMF from the medial side, it is not without complications and implant-related irritation.

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Title: Lateral approach for intramedullary nailing of displaced midshaft clavicle fractures; a retrospective cohort study
Authors: Nina Kabelitz
Method Kabelitz
Herman Frima
Alexandra Rehm
Christoph Sommer
Christian Michelitsch
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Clavicle Fracture
Elastic-Stable Intramedullary Nailing
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01620-4

At a glance: The STEP trials

Springer Medicine

Lateral approach for intramedullary nailing of displaced midshaft clavicle fractures; a retrospective cohort study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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