title: Titanium elastic stable intramedullary nailing of displaced midshaft clavicle fractures: A review of 38 cases.
abstract: BACKGROUND
  Clavicle fractures accounting for 3 to 5% of all adult fractures are usually treated non-operatively. There is an increasing trend toward their surgical fixation. The aim of our study was to investigate the outcome following titanium elastic stable intramedullary nailing (ESIN) for midshaft non-comminuted clavicle fractures with >20 mm shortening/displacement.
  
  
  METHODS
  A total of 38 patients, which met inclusion criteria, were reviewed retrospectively. There were 32 males and six females. The mean age was 27.6 years. The patients were assessed for clinical/radiological union and by Oxford Shoulder and QuickDASH scores. 71% patients required open reduction.
  
  
  RESULTS
  100% union was achieved at average of 11.3 weeks. The average follow-up was 12 months. The average Oxford Shoulder and QuickDASH scores were 45.6 and 6.7, respectively. 47% patients had nail removal. One patient had lateral nail protrusion while other required its medial trimming.
  
  
  CONCLUSIONS
  In our hands, ESIN is safe and minimally invasive with good patient satisfaction, cosmetic appearance, and overall outcome.
authors.affiliation: Dewsbury and District Hospital, Dewsbury, West Yorkshire, England.
authors.forename: Anish P
authors.initials: AP
authors.lastname: Kadakia
authors.forename: Rohit
authors.initials: R
authors.lastname: Rambani
authors.forename: Faisal
authors.initials: F
authors.lastname: Qamar
authors.forename: Steven
authors.initials: S
authors.lastname: McCoy
authors.forename: Lutz
authors.initials: L
authors.lastname: Koch
authors.forename: Balachandran
authors.initials: B
authors.lastname: Venkateswaran