Comparative Study between Plating and Titanium Elastic Nailing System in Mid-clavicular Fractures in Andhra Population

  • Medisetty Vinod Kumar Assistant Professor, Department of Orthopaedics
Keywords: Disabilities of the arm, shoulder and hand score, Fluoroscopy, Titanium elastic nailing system, Mid-shaft fracture, Plating


Background: Although non-operative management of mid-shaft clavicle fractures is standard method, to avoid non-union or
mal-union of displaced fractures of clavicle plating or titanium elastic nailing system (TENS) techniques are widely used. Hence,
their post-surgical complications were studied.
Materials and Methods: Out 26, 13 were treated with TENS and 13 with plating routines blood examination electrocardiogram
radiological study was carried out and operated under general anesthesia.
Results: Mean blood loss, operative timing, and size of the wound mean open reduction were highly significant in nail technique
method. (P < 0.00) Post-surgical complications were least in nailing technique. The rate of union was 100% in both techniques.
Mean Dash score rate in 1st, 3rd, and 6th months was highly significant in nail technique (P < 0.001).
Conclusion: Although both techniques were equally effective at treating displaced mid-clavicular fractures, due to least postsurgical
complications TENS is preferred than plating technique.

Author Biography

Medisetty Vinod Kumar, Assistant Professor, Department of Orthopaedics

Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India


Robinson CM. Fractures of the clavicle in the adults.
Epidemiology and classification. J Bone Joint Surg
2. Canadian Orthopaedic Trauma Society. Non-operative treatment displaced mid-shaft clavicle fraction. J Bone Joint
Surg 2007;89 A:1-10.
3. Denard PJ, Koval KJ. Management of mid-shaft clavicle
fractures in adults. Am J Orthop 2005;34:527-36.
4. Niemeier U, Zimmermann HG. Kuntscher’s open
intramedullary nailing of the clavicle on alternative in the
treatment of an old clavicle fracture. Chirug 1990;61:464-6.
5. Nardqvist A, Peterson C. The incidence of fractures of
clavicle. Clin Orthop 1994;3:127-32.
6. Rowe CR. An atlas of anatomy and treatment of mid
clavicular frctures. Clin Orthob 1968;58:29-42.
7. Neer CS – Non-union of the clavicle fractures – JAMA 1960,
17; 1006-11.
8. Mckee MD. Optimal Treatment of Displaced Mid-shaft
Fractures of the Clavicle. Vol. 49. Philadelphia, PA:
Sounders; 2009. p. 774-84.
9. Golish SR, Olivero JA. A biomechanical study of plate
versus intramedullary devices for mid-shift clavicle fixation.
J Orthob Surg Res 2008;16:328-31.
10. Liu HH, Chang CH. Comparison of plates versus
intramedullary nails for fixation of displaced mid-shift
clavicular fractures. J Trauma 2010;69:82-7.