The Clinical Outcome And Comparison Of The Threaded Elastic Intramedullary Nail And The Plate For Clavicle Fracture

Objective This study compared threaded elastic intramedullary nail(TEIN)fixation with plate fixation in patients with displaced midshaft clavicle fractures(DMCF).Methods A total of 77 patients(47 men,30 women)with a midshaft clavicle fracture were treated by internal fixation with TEIN(45 cases)or a reconstruction plate(32 cases)in The Fourth Clinical College of Tianjin Medical University.General and clinical information of patients included were collected.If the data were normal distributed,Student’s T test was used,otherwise Wilcoxon rank sum test was applied.For qualitative data,chi-square test and Fisher’s exact test were used.All the statistical operation was managed by SPSS.Results 1.The average age of control group was 42.2 years,the average age of study group was 39.4 years,and there was no significant difference between the two groups.2.The mechanisms of injure included falling,sport,vehicle accidents,bicycling,and others,and there was no significant difference between the two groups.3.No significant difference was found between the two groups in fracture classification.4.The operation time of intramedullary nail group and plate group was 36.93±8.32 min and 56.91±7.77 min,respectively.The time for X-ray exposure was 8.32±1.93 s,6.70±1.17 s,respectively.Blood loss was 25.00 ml and 122.50 ml,respectively.Bone union time was 12.00 weeks,13.50 weeks,respectively.All these parameters are significantly different.5.No significant difference was found in the rate of complications between the two groups.DASH and Constant scores were significantly higher in the TEIN groups at 1 months,3 months,6 months postoperatively,while no significant difference was found at 12 months postoperatively.All patients in TEIN group removed theintramedullary nail,with 56% of patients removing plate in the other group.Conclusion TEIN technique is less invasive,producing better functional and cosmetic results to patients who have suffered from displaced midshaft clavicular fractures than plate fixation.TEIN worths popularizing among primary level hospitals.