Titanium elastic nails, open reduction internal fixation and non-operative management for middle third clavicle fractures: a comparative study.

OBJECTIVES: To compare clinical outcomes between titanium elastic nails (TENS), open reduction internal fixation (ORIF) and non-operative treatment options at mean 30 months in Allman type 1 fractures of the clavicle.

DESIGN: Retrospective case matched.

SETTING: Tertiary Trauma Centre, UK.

PATIENTS: Treatment method was based on surgeon choice although there was no difference between groups in terms of age or gender. Those treated non-operatively tended to have a less severe fracture pattern. There were 25 patients treated with TENS, 24 with ORIF and 41 treated conservatively. Main outcome measurements are qDASH questionnaire, patient satisfaction question and clinical complication rate.

RESULTS: Patients managed with TENS had significantly better clinical outcomes than both plate fixation and non-operatively managed groups.

CONCLUSIONS: This study supports the use of TENS fixation of middle third clavicle fractures in significantly displaced Allman type 1 injuries.