title: Elastic stable intramedullary nailing of midclavicular fractures in adults: 32 patients followed for 1-5 years.
abstract: BACKGROUND
  Osteosynthesis of clavicular fractures is sometimes indicated. Since plate fixation may lead to complications, we have used elastic stable intramedullary nailing and report our experience of midclavicular fractures in 32 adults.
  
  
  METHODS
  From 2000 to 2005, we treated 32 adults (26 men), median age 40 (19-66) years, by intramedullary nailing with a titanium elastic nail (TEN). All patients were re-examined after median 27 (12-59) months.
  
  
  RESULTS
  Nonunion was not observed. 20 clavicles healed without shortening. 12 clavicles healed with shortening of more than 5 mm. Migration of the TEN in 8 patients required secondary shortening of the nail in 5 of them. Nail breakage after fracture healing was observed twice. The nails were removed in 29 patients after a median of 6 (1.3-15) months postoperatively. No patient sustained a re-fracture after TEN removal. The mean Constant score was 95 (SD 1.9) points and the mean DASH score was 5 (SD 2.3) points.
  
  
  CONCLUSIONS
  Intramedullary stabilization of midclavicular fractures with a titanium elastic nail is a minimally invasive technique with good cosmetic and functional results. Intramedullary fixation can be seen as an alternative to plate fixation and nonoperative treatment.
authors.affiliation: Department of Trauma Surgery, University Hospital of Bonn Medical Center, DE-53105 Bonn, Germany. marcus.mueller@yahoo.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Mueller
authors.forename: Christof
authors.initials: C
authors.lastname: Burger
authors.forename: Andreas
authors.initials: A
authors.lastname: Florczyk
authors.forename: Nadine
authors.initials: N
authors.lastname: Striepens
authors.forename: Christoph
authors.initials: C
authors.lastname: Rangger
mesh_terms: D000328:Adult; D001858:Bone Nails / Q000009:adverse effects; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium