Intramedullary clavicle fixation with single large fragmentary screw

Area of Science:

• Orthopedic surgery
• Traumatology
• Skeletal fixation

Background:

• Clavicle fracture treatment historically nonoperative, but operative management shows promise for specific patterns.
• A novel technique using a 6.5-mm cannulated screw for displaced midshaft clavicle fractures was developed.

Purpose of the Study:

• To evaluate the efficacy of a novel 6.5-mm cannulated screw fixation technique for displaced midshaft clavicle fractures.
• To assess outcomes including union rates, complications, and functional recovery.

Main Methods:

• A consecutive series of 15 male patients with displaced midshaft clavicle fractures treated between 2007-2012.
• Surgical fixation using a 6.5-mm cannulated screw for fractures with significant shortening or displacement.
• Postoperative management involved an abduction brace for 6 weeks with progressive physical therapy.

Main Results:

• All 15 patients achieved radiographic union at an average of 5.7 months.
• Three patients experienced superficial wound infections; six required hardware removal.
• Full range of motion and strength were regained in all patients compared to the contralateral side.

Conclusions:

• The 6.5-mm cannulated screw technique offers a minimally invasive option for specific clavicle fractures.
• Advantages include limited soft tissue stripping and use of a readily available implant.
• This method is recommended for transverse fractures in males over 180 cm, presenting within 14 days, with suitable clavicle dimensions.