title: Minimally invasive intramedullary nailing of clavicular fractures by a new titanium elastic nail.
abstract: OBJECTIVE
  The aim of this study was to evaluate clinical results of a new design titanium elastic nail (TEN) for displaced midshaft clavicular fractures.
  
  
  METHODS
  Between February 2012 and December 2013, a total 36 patients with displaced midshaft clavicular fractures were treated with intramedullary nailing stabilization with our new design TEN. Blood loss, mean times of operation, postoperative complications, hospital stays and time to bone union was recorded. The outcomes were evaluated with radiographic assessment, visual analog scale (VAS) score, the Constant-Murley, and the disabilities of the arm, shoulder, and hand (DASH) scores.
  
  
  RESULTS
  The mean blood loss was 50.278 ± 10.753 ml, while the mean operation, hospital stay and bone union times were 46.417 ± 9.232 min, 10.056 ± 2.672 days and 11.583 ± 2.729 weeks, respectively. After removal of the TENs at a mean of 10.2 months (range, 8-13 months) after surgery, no re-fracture and nonunion was found in any patient. Two cases of shoulder back stabbing pain were spontaneously resolved later. The mean fracture healing time was 12 weeks. The VAS score and motion ranges of shoulder joint were significantly improved postoperatively (P < 0.001). The shoulder function recovery showed the excellent results with the mean Constant-Murley score of 93.389 ± 2.749 and DASH scores of 2.528 ± 1.567.
  
  
  CONCLUSIONS
  Our new TEN design used in intramedullary fixation might be a safe and effective technique for treatment of displaced midshaft clavicular fractures.
  
  
  METHODS
  Level IV, therapeutic study.
authors.affiliation: Zhoupu Hospital, Shanghai, China. Electronic address: fubeigang@126.com.
authors.forename: Beigang
authors.initials: B
authors.lastname: Fu
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D001858:Bone Nails; D002968:Clavicle / Q000601:surgery*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D020127:Recovery of Function; D012720:Severity of Illness Index; D014025:Titanium
chemical_list: D014025:Titanium
keywords: Displaced midshaft clavicular fractures; Minimally invasive treatment; Titanium elastic nail