Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients
Introduction: Midshaft clavicle fractures are common, with comminuted variants posing a higher risk of non-union, often necessitating surgical intervention. Anatomical repair is critical due to the clavicle’s sole osseous connection between the shoulder and trunk, impacting functional outcomes. Case...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Indian Orthopaedic Research Group
2025-07-01
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| Series: | Journal of Orthopaedic Case Reports |
| Subjects: | |
| Online Access: | https://jocr.co.in/wp/2025/07/01/management-of-comminuted-midshaft-clavicle-fractures-with-interfragmentary-screws-non-invasive-screw-fixation-knot-technique-and-plating-in-83-patients/ |
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| Summary: | Introduction:
Midshaft clavicle fractures are common, with comminuted variants posing a higher risk of non-union, often necessitating surgical intervention. Anatomical repair is critical due to the clavicle’s sole osseous connection between the shoulder and trunk, impacting functional outcomes.
Case Series:
This retrospective study evaluated 83 patients (74 males, nine females, aged 18–65 years) surgically treated for midshaft clavicle fractures (2010–2023). Dominant-side fractures accounted for 87% of cases. Severe comminution was managed using 2.7 mm cortical interfragmentary screws and the NISE knot technique with plating. Follow-up spanned 18 months, assessing clinical and radiological outcomes. Patients regained near-complete shoulder motion within 3 weeks. Complications included visible deformity (n = 4), keloid formation (n = 3), scar hypoesthesia (n = 5), and one refracture with plate failure. No non-unions occurred, though two cases exhibited delayed union. Radiological and functional recovery was achieved in 97.6% of cases, with minimal long-term sequelae.
Conclusion:
Surgical fixation of 3- or 4-part comminuted midshaft clavicle fractures using plate and screws demonstrates high union rates, rapid functional recovery, and low complication rates. This approach is recommended for complex fractures, as non-operative management risks non-union, malunion, and functional deficits. |
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| ISSN: | 2250-0685 2321-3817 |