Kirschner Wire Temporary Intramedullary Fixation Combined with a Locking Anatomical Plate versus a Reconstruction...

We investigate the clinical efficacy of Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate for the treatment of comminuted clavicular fractures. We retrospectively studied 112 patients [80 (71%) men] treated between February 2007 and February 2014. The patients were allocated to treatment with Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate [minimally invasive group (G_M)] or a reconstruction plate [traditional group (G_T)]. The 112 patients were followed up for 12-48 months (mean, 14 months). The operation time was significantly shorter in G_M than in G_T. Intraoperative blood loss was significantly less in G_M than in G_T. The total incision length was significantly shorter and the visual analog scale pain score 24 h after surgery was significantly lower in G_M than in G_T. Fracture healing time was significantly shorter and the complication rate was significantly lower in G_M than in G_T. No significant difference in shoulder function score was observed between groups. We recommend Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate as the treatment of choice for comminuted clavicular fractures because of the shorter operation time, lesser intraoperative blood loss, easier reduction of the operation, quicker fracture healing, and lower postoperative complication rate.