title: Outcome of intramedullary fixation of clavicular fractures.
abstract: We conducted a retrospective, single-center (tertiary referral center with associated level I trauma center) review to evaluate the outcome of open reduction and internal fixation (ORIF) with intramedullary (IM) clavicle pin of displaced clavicular fractures. Sixty-eight displaced midshaft clavicle fractures in 68 patients underwent ORIF with IM clavicle pins. Patients were identified through a perioperative database by searching for Current Procedural Terminology (CPT) codes. Union was the primary outcome. Secondary outcomes included time to union, pain, incidence of nonunion and delayed union, postoperative range of motion, and incidence of complications. Sixty-six fractures (97%) went on to union. Complications included painful hardware (44%), deep and superficial wound infections (10%), and hardware failure (4%), including pin breakage and extrusion. Postoperative shoulder pain was present in 10% of patients and limited shoulder range of motion in 12%. IM pin fixation can provide good outcomes, even for fractures with a significant amount of shortening and comminution.
authors.affiliation: Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Diane E S
authors.initials: DE
authors.lastname: Payne
authors.forename: Walter H
authors.initials: WH
authors.lastname: Wray
authors.forename: David S
authors.initials: DS
authors.lastname: Ruch
authors.forename: Robert D
authors.initials: RD
authors.lastname: Zura
authors.forename: Claude T
authors.initials: CT
authors.lastname: Moorman
mesh_terms: D000328:Adult; D017760:Bone Malalignment / Q000601:surgery; D001858:Bone Nails; D002968:Clavicle / Q000293:injuries / Q000601:surgery*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome