Comparative retrospective analysis of the surgical treatment of intramedullary fixation versus plate for clavicle fracture

Abstract

Objective: Studies confirm the benefit of surgical treatment for fixation of displaced midshaft clavicle fractures. Plate fixation and intramedullary nail are the two most used techniques. The purpose of this study is to compare these two surgical techniques. Method: Retrospective study, performed through the evaluation of patients treated for displaced midshaft clavicle fracture with intramedullary nail and plate and screws. Socioeconomic variables were collected, a visual pain scale questionnaire was applied, the shoulder function was measured using CONSTANT and UCLA scores, and radiography was performed to verify the consolidation and evaluation of the final clavicle shortening. Results: Sixty-five patients were evaluated, 36 (55.4%) of which were submitted to clavicle fixation with plate and screws and 29 (44.6%) with intramedullary nail. The median shortening was 0.1mm for plate and 5.8mm for nail (p = 0.001). The UCLA score shows an average of 35 in the plate group and 35 in the intramedullary group. The median CONSTANT scores were 96.5 for plate and 95 for nail, without significance. In all, 13 (20%) complications were registered, 9 fixed with plate and 4  fixed with intramedullary nail. The most common complication was skin erosion with exposure of the synthetic material. Conclusion: The two techniques present satisfactory results for the treatment of displaced midshaft clavicle fractures.