title: Reconstruction plate versus minimal invasive retrograde titanium elastic nail fixation for displaced midclavicular fractures.
abstract: BACKGROUND
  Nonoperative management of midshaft clavicle fractures (MSCFs) is standard; however, it is now generally accepted that displaced midshaft clavicle fractures benefit from internal fixation. Plating and intramedullary fixation have become the accepted methods of fixation. The purpose of this study was to see if one method of fixation of clavicle fractures has a lower complication rate and higher union rate than the other.
  
  
  METHODS
  Between December 2003 and September 2008, 38 patients were treated randomly by either plating (plate group) or retrograde nailing (RTEN group). Primary outcome measures included functional Constant scores, radiological union rate and union time. Clinical and radiological assessments were performed at the 6th week and the 3rd, 6th and 12th month postoperatively. Secondary outcome measures included the perioperative data (mean surgery time, blood loss, wound size, and hospital stay), and the complication rates.
  
  
  RESULTS
  Similar results were found between the two groups regarding functional and radiological outcome after the 12th week (P > 0.05). However, earlier union and functional recovery were obtained at the 6th week for the RTEN group (P < 0.05). The rate of complications was significantly higher (15.8%) in the plate group compared with the RTEN group (0%; P > 0.05). In the plate group, significantly higher values were obtained for the perioperative data (P < 0.001).
  
  
  CONCLUSIONS
  Both techniques are equally effective at treating displaced midclavicular fractures, and give better function and fewer complications than nonoperative treatment. The RTEN technique has more advantages and lower complications than plating, making its use more favorable. It is recommended for athletes and young active individuals, and can be used as an alternative to conservative treatment or plate fixation.
authors.affiliation: Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, 5 Al-Emam Al-Sha'rawy str., Assefarat District, Nasr City, Cairo, Egypt. gelsobhi@hotmail.com
authors.forename: Jamal E H
authors.initials: JE
authors.lastname: Assobhi
mesh_terms: D000328:Adult; D001858:Bone Nails; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D020127:Recovery of Function; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium