title: Plate versus titanium elastic nail in treatment of displaced midshaft clavicle fractures: A comparative study.
abstract: BACKGROUND
  With changing trends in treatment of displaced midshaft clavicle fractures (DMCF), plating remains the standard procedure for fixation. An attracting alternative method of fixation is the titanium elastic nailing (TEN). However, prospective randomized studies comparing the two methods of fixation are lacking. We assessed the effectiveness of minimally invasive antegrade TEN and plating technique for the treatment of DMCF.
  
  
  METHODS
  80 unilateral displaced midclavicular fractures operated between October 2010 and May 2013 were included in study. This prospective comparative study was approved by the local ethical committee. Followups were at 2(nd) and 6(th) weeks and subsequently at 3, 6, 12, 18 and 24 months postoperatively. Primary outcome was measured by the Constant score, union rate and difference in clavicular length after fracture union. Secondary outcome was measured by operative time, intraoperative blood loss, wound size, cosmetic results and complications.
  
  
  RESULTS
  During analysis, we had 37 patients in the plate group and 34 patients in the TEN group. There was no significant difference in Constant scores between the two groups. However, faster fracture union, lesser operative time, lesser blood loss, easier implant removal and fewer complications were noted in the TEN group.
  
  
  CONCLUSIONS
  The use of minimally invasive antegrade TEN for fixation of displaced midshaft clavicle fractures is recommended in view of faster fracture union, lesser morbidity, better cosmetic results, easier implant removal and fewer complications; although for comminuted fractures plating remains the procedure of choice.
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Partha
authors.initials: P
authors.lastname: Saha
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Prasenjit
authors.initials: P
authors.lastname: Datta
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Saankritya
authors.initials: S
authors.lastname: Ayan
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Anant Kumar
authors.initials: AK
authors.lastname: Garg
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Utpal
authors.initials: U
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Orthopaedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Srikanta
authors.initials: S
authors.lastname: Kundu
keywords: Clavicle fractures; Fractures; bone plates; clavicle; fracture fixation; internal; internal fixation of clavicle fractures; intramedullary nailing; plate; titanium elastic nailing