title: Midshaft clavicular fractures: comparison of intramedullary pin and plate fixation.
abstract: BACKGROUND
  Intramedullary pin and plate fixation for midshaft clavicular fractures both have their proponents, but little comparative data are available. We performed a retrospective comparison of these 2 techniques.
  
  
  METHODS
  A retrospective review was performed on 40 consecutive patients with closed, simple, or wedge-type midshaft clavicular fractures that were identified from a prospectively collected orthopedic trauma database. Eight patients were excluded due to incomplete follow-up. Intramedullary pins were used in 18 patients and plates in 14; of these, 7 plates were placed superiorly, 6 anteriorly, and 1 inferiorly. Treatment method was determined by preference of the treating surgeon.
  
  
  RESULTS
  Among the patients treated with intramedullary pin fixation, all 18 fractures healed, and each underwent a planned procedure for pin removal. Complications included 1 intraoperative pin breakage, 1 superficial wound infection, 2 prominent symptomatic pins, and 1 transient brachial plexopathy. Among the patients treated with plating, delayed union occurred in 1, and refractures occurred in 2 (1 required a second procedure). Three patients underwent plate removal for symptomatic hardware. No patients in either group had significant loss of shoulder motion.
  
  
  CONCLUSIONS
  Intramedullary pin fixation for acute, simple, or wedge-type midshaft clavicular fractures provides a safe and predictable alternative to plate and screw fixation.
authors: Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA, USA.
authors: Conor P
authors: CP
authors: Kleweno
authors: Andrew
authors: A
authors: Jawa
authors: Jessica H
authors: JH
authors: Wells
authors: Travis G
authors: TG
authors: O'Brien
authors: Laurence D
authors: LD
authors: Higgins
authors: Mitchel B
authors: MB
authors: Harris
authors: Jon J P
authors: JJ
authors: Warner
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D002968:Clavicle / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D005596:Fractures, Closed / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult