title: Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?
abstract: BACKGROUND
  Intramedullary nailing for fractures of middle third clavicle has become increasingly popular. Though open nailing has been widely described, closed nailing finds less mention.
  
  
  OBJECTIVE
  In this study we compared closed nailing with open nailing in fractures of middle third of clavicle to assess if the former holds any advantage.
  
  
  METHODS
  34 patients with closed nailing were compared to 31 patients with open nailing in terms of operative time, length of incision, pain, time to union and functional outcome.
  
  
  RESULTS
  Only operative time and length of incision were significantly more in open group than in closed group.
  
  
  CONCLUSIONS
  We believe that closed reduction can be attempted in all patients undergoing nailing for middle third clavicle fracture but surgeon should have a low threshold to open the fracture if closed reduction fails as functional outcome and time to union remains unaffected.
authors.affiliation: Shashwat Hospital, Kothrud, Pune, Maharashtra, India.
authors.forename: Hrushikesh
authors.initials: H
authors.lastname: Saraf
authors.affiliation: Department of Orthopaedics, MIMER Medical College, Talegaon Dabhade, Pune, India.
authors.forename: Sarang
authors.initials: S
authors.lastname: Kasture
keywords: Clavicle; Fracture; Nailing; TENS; Trauma