title: Retrospective comparison of titanium elastic nail (TEN) and reconstruction plate repair of displaced midshaft clavicular fractures.
abstract: BACKGROUND
  Titanium elastic nails (TENs) are commonly used to repair displaced midshaft clavicular fractures. Although several clinical studies have shown that the use of TENs is more effective and less invasive than traditional plate fixation, high rates of complications associated with TENs have been reported. This retrospective study compared the use of TENs with reconstruction plates in the treatment of displaced midshaft clavicular fractures.
  
  
  METHODS
  From January 2005 to July 2007, 141 patients with displaced midshaft clavicular fractures were treated with TEN or plate fixation. At 6 and 24 months postoperatively, we evaluated the patients' general health, operative complications, and functional recovery.
  
  
  RESULTS
  The mean bone union time of TEN patients was 12.4 ± 3.4 weeks, whereas that in the plate group was 14.4 ± 3.7 weeks. The time of union was significantly shorter in the TEN group than that in the plate group. There was no significant difference between these 2 groups' rates of complications such as nonunion or malunion. Shoulder function scores were significantly better in the TEN group than in the plate group at 6 months postoperatively. There was no significant difference at 24 months postoperatively. Patients were more satisfied with the cosmetic appearance and overall outcome after TEN repair than after plate fixation.
  
  
  CONCLUSIONS
  TEN fixation of displaced midshaft clavicular fractures allows for a faster functional recovery, higher patient satisfaction, and a more cosmetically satisfactory appearance than plate fixation. The complication rates of both TENs and reconstruction plates were similar.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Chen
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Wei
authors.forename: Chi
authors.initials: C
authors.lastname: Zhang
authors.forename: Bing-Fang
authors.initials: BF
authors.lastname: Zeng
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Xue
authors.forename: Xue-Tao
authors.initials: XT
authors.lastname: Xie
authors.forename: Ye
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D001858:Bone Nails / Q000009:adverse effects; D001860:Bone Plates; D016022:Case-Control Studies; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult