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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| Format: | Article |
| Language: | English |
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Indian Orthopaedic Research Group
2025-07-01
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| Series: | Journal of Orthopaedic Case Reports |
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| 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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| author | Sahil Kale Dinesh Kale Omkar Kerkar Kavya Botta Arvind Vatkar Sachin Kale |
| author_facet | Sahil Kale Dinesh Kale Omkar Kerkar Kavya Botta Arvind Vatkar Sachin Kale |
| author_sort | Sahil Kale |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-26a6d9de26874a8bb4f3b6a6db256b36 |
| institution | Kabale University |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-26a6d9de26874a8bb4f3b6a6db256b362025-08-20T03:36:45ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-07-0115723724110.13107/jocr.2025.v15.i07.5836Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 PatientsSahil KaleDinesh KaleOmkar KerkarKavya BottaArvind VatkarSachin KaleIntroduction: 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.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/(according to mesh)-clavicle fracturesmidshaft clavicle fracturescomminuted fracturessurgical fixationsuture techniques (including nise knot technique)interfragmentary screwsanatomical platesfunctional outcomesunion ratesoxford shoulder score |
| spellingShingle | Sahil Kale Dinesh Kale Omkar Kerkar Kavya Botta Arvind Vatkar Sachin Kale Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients Journal of Orthopaedic Case Reports (according to mesh)-clavicle fractures midshaft clavicle fractures comminuted fractures surgical fixation suture techniques (including nise knot technique) interfragmentary screws anatomical plates functional outcomes union rates oxford shoulder score |
| title | Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients |
| title_full | Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients |
| title_fullStr | Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients |
| title_full_unstemmed | Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients |
| title_short | Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients |
| title_sort | management of comminuted midshaft clavicle fractures with interfragmentary screws non invasive screw fixation knot technique and plating in 83 patients |
| topic | (according to mesh)-clavicle fractures midshaft clavicle fractures comminuted fractures surgical fixation suture techniques (including nise knot technique) interfragmentary screws anatomical plates functional outcomes union rates oxford shoulder score |
| url | 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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