title: Fixation of mid-third clavicular fractures with knowles pins: 78 patients followed for 2-7 years.
abstract: From January 1993 to December 1997, we treated 78 (75 fresh, 1 delayed union and 2 nonunion) fractures of the mid-third clavicle with open reduction and internal fixation using 3.8 mm Knowles pins. All patients used an arm sling for 2-6 weeks after surgery, and were told to avoid vigorous exercise or work with heavy loads for the next 6 weeks. 73 fractures healed within 6 months. 3 complications occurred relating to the surgical procedures. The final rate of bone union was 77/78, although 3 patients showed a delay in bone union and 1 fracture was revised because of a loosened Knowles pin. After a mean follow-up of 49 (24-86) months, the average shoulder function, as evaluated by a modified Constant-Murley score, was 97% versus the contralateral shoulder. We suggest that if surgery is indicated, open reduction and internal fixation using a Knowles pin is an effective method for managing mid-third clavicular fractures.
authors.affiliation: Department of Orthopaedics, Tri-Service General Hospital, Taipei, Taiwan, Republic of China. smc1211@ms45.hient.net
authors.forename: Cheng-Mien
authors.initials: CM
authors.lastname: Chu
authors.forename: Shyu-Jye
authors.initials: SJ
authors.lastname: Wang
authors.forename: Leou-Chyr
authors.initials: LC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D002968:Clavicle / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology