Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing

Background This study aimed to compare the outcomes and complications of active young adults undergoing open reduction and plate fixation (ORPF) and intramedullary nailing (IMN) for displaced midshaft clavicle fractures (MCFs). Methods A retrospective review was performed on all patients undergoing...

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Main Authors: Ji Un Kim, Ji Young Yoon, Hyung Jun Park, Jung Ho Park
Format: Article
Language:English
Published: Korean Shoulder and Elbow Society 2024-11-01
Series:Clinics in Shoulder and Elbow
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Online Access:http://cisejournal.org/upload/pdf/cise-2024-00605.pdf
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author Ji Un Kim
Ji Young Yoon
Hyung Jun Park
Jung Ho Park
author_facet Ji Un Kim
Ji Young Yoon
Hyung Jun Park
Jung Ho Park
author_sort Ji Un Kim
collection DOAJ
description Background This study aimed to compare the outcomes and complications of active young adults undergoing open reduction and plate fixation (ORPF) and intramedullary nailing (IMN) for displaced midshaft clavicle fractures (MCFs). Methods A retrospective review was performed on all patients undergoing ORPF and IMN of complete MCFs at a single center between 2018 and 2022. Patients who were younger than 60 years with radiographic follow-up until union were included in the study. The mean age of the patients was 33.1 years. Outcome measures were achievement of union, time to healing, residual deformity, complications, and need for additional procedures. Results Of 39 patients, 29 underwent ORPF and 10 underwent IMN. Plate fixation provided faster functional recovery in the first 6 months, but no difference was observed after 1 year. All fractures in the IMN group healed (100%), compared to 90% in the ORPF group (P=0.08). Mean time to union was 21±8.9 weeks and was significantly different between the two groups (P<0.01), with the ORPF group averaging 23.1 weeks and the IMN group 20.8 weeks. Nonunion rates were higher in the ORPF group (10.3%) than in the IMN group (0%), but the difference was not significant (P=0.08). Conclusions Both methods restored patients to their pre-injury functional levels. However, IMN, with its higher healing rate, fewer required revision surgeries, and lower incisional numbness, appears to be the preferred method for treating MSFs without comminution in young adults. Level of evidence III.
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spelling doaj-art-bcdb58db2a6542c89aee6b2920180d8a2025-08-20T03:53:46ZengKorean Shoulder and Elbow SocietyClinics in Shoulder and Elbow2288-87212024-11-0127444745310.5397/cise.2024.006051011Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailingJi Un Kim0Ji Young Yoon1Hyung Jun Park2Jung Ho Park3 Department of Orthopaedic Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea Department of Orthopaedic Surgery, National Police Hospital, Seoul, Korea Department of Orthopaedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea Department of Orthopaedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, KoreaBackground This study aimed to compare the outcomes and complications of active young adults undergoing open reduction and plate fixation (ORPF) and intramedullary nailing (IMN) for displaced midshaft clavicle fractures (MCFs). Methods A retrospective review was performed on all patients undergoing ORPF and IMN of complete MCFs at a single center between 2018 and 2022. Patients who were younger than 60 years with radiographic follow-up until union were included in the study. The mean age of the patients was 33.1 years. Outcome measures were achievement of union, time to healing, residual deformity, complications, and need for additional procedures. Results Of 39 patients, 29 underwent ORPF and 10 underwent IMN. Plate fixation provided faster functional recovery in the first 6 months, but no difference was observed after 1 year. All fractures in the IMN group healed (100%), compared to 90% in the ORPF group (P=0.08). Mean time to union was 21±8.9 weeks and was significantly different between the two groups (P<0.01), with the ORPF group averaging 23.1 weeks and the IMN group 20.8 weeks. Nonunion rates were higher in the ORPF group (10.3%) than in the IMN group (0%), but the difference was not significant (P=0.08). Conclusions Both methods restored patients to their pre-injury functional levels. However, IMN, with its higher healing rate, fewer required revision surgeries, and lower incisional numbness, appears to be the preferred method for treating MSFs without comminution in young adults. Level of evidence III.http://cisejournal.org/upload/pdf/cise-2024-00605.pdfyoung adultintramedullary fracture fixationclavicle
spellingShingle Ji Un Kim
Ji Young Yoon
Hyung Jun Park
Jung Ho Park
Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
Clinics in Shoulder and Elbow
young adult
intramedullary fracture fixation
clavicle
title Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
title_full Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
title_fullStr Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
title_full_unstemmed Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
title_short Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing
title_sort surgical treatment options of displaced midshaft fractures of the clavicle in young adults plate fixation versus intramedullary nailing
topic young adult
intramedullary fracture fixation
clavicle
url http://cisejournal.org/upload/pdf/cise-2024-00605.pdf
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AT hyungjunpark surgicaltreatmentoptionsofdisplacedmidshaftfracturesoftheclavicleinyoungadultsplatefixationversusintramedullarynailing
AT junghopark surgicaltreatmentoptionsofdisplacedmidshaftfracturesoftheclavicleinyoungadultsplatefixationversusintramedullarynailing