title: [Elastic titanium nails in minimally invasive osteosynthesis for mid-clavicular fractures].
abstract: BACKGROUND
  In up to 31% of cases, conservative treatment of mid-clavicular fractures leads to unsatisfactory results. The aim of this study was to define the value of minimally invasive elastic stable intramedullary nailing (ESIN) of mid-clavicular fractures with titanium elastic nails.
  
  
  METHODS
  Within 5 years, ESIN was performed in 45 patients. We studied the functional results and complications.
  
  
  RESULTS
  Retrospectively we analysed the results of all patients at a mean follow-up of 24.7+/-2.4 months. Iatrogenic perforation of the lateral cortex occurred twice and medial migration in eight patients. Superficial skin infection developed in one. Nail breakage after fracture healing was observed twice. Twelve patients sustained clavicular shortening of > or =5 mm in relation to the intact contralateral side. After 6 months the mean constant score was 94.3+/-2 points, and the mean DASH score was 5.4+/-2.2 points.
  
  
  CONCLUSIONS
  Intramedullary stabilisation of mid-clavicular fractures with titanium elastic nails is a minimally invasive technique with good functional results. Patients must be informed about the possibility of open reduction in about half of the cases as well as shoulder asymmetry, migration of the nail, and iatrogenic nerve and vessel injury.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn. marcus.mueller@yahoo.de
authors.forename: M C
authors.initials: MC
authors.lastname: Müller
authors.forename: C
authors.initials: C
authors.lastname: Burger
authors.forename: A
authors.initials: A
authors.lastname: Florczyk
authors.forename: N
authors.initials: N
authors.lastname: Striepens
authors.forename: C
authors.initials: C
authors.lastname: Rangger
mesh_terms: D000328:Adult; D001858:Bone Nails; D001917:Brachial Plexus / Q000293:injuries; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D020878:Device Removal; D004548:Elasticity; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014025:Titanium; D014057:Tomography, X-Ray Computed
chemical_list: D014025:Titanium