title: Minimally invasive fixation of midclavicular fractures with threaded elastic intramedullary nails.
abstract: BACKGROUND
  Intramedullary fixation of midclavicular fractures has been described as a minimally invasive operation with few complications. The purpose of this study was to assess the effectiveness of the threaded elastic intramedullary nail (TEIN, made in Kang Li Min Medical Devices Co. Ltd., Tianjin, China) in the treatment of midclavicular fractures.
  
  
  METHODS
  Between 2010 and 2013, 45 patients with midclavicular fractures, who received closed reduction and intramedullary fixation, were treated with the TEIN in our department. Clinical outcomes were evaluated after a follow-up of 14 (3-42) months. We used the Constant score and the disabilities of the arm, shoulder and hand (DASH) scale to determine the outcomes.
  
  
  RESULTS
  The mean time of the operation was 22.4 (13-40) min. The rate of the closed reduction was 64 %. The mean time of the follow-up was 14 (3-42) months. With regard to complications, there was no occurrence of neurovascular impairment, pulmonary injuries, infection, shortening, refracture or nonunion. All of the patients displayed excellent shoulder function, with a mean Constant shoulder score of 96.5 (64-100) and a mean DASH score of 1.4 (range 0-100) at the latest follow-up.
  
  
  CONCLUSIONS
  Closed reduction and intramedullary fixation of midclavicular fractures with the TEIN present a safe and minimally invasive surgical technique, achieving excellent aesthetic and early recovery after surgery.
  
  
  METHODS
  Treatment Study, Level II.
authors.affiliation: Department of Orthopedics, Tianjin Fourth Central Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, 300140, People's Republic of China, abinbhb@126.com.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Bi
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Wang
authors.forename: Qingguang
authors.initials: Q
authors.lastname: Xiong
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Zhao
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D061646:Operative Time; D016896:Treatment Outcome; D055815:Young Adult