Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

BACKGROUND: Intramedullary nailing for fractures of middle third clavicle has become increasingly popular. Though open nailing has been widely described, closed nailing finds less mention.

OBJECTIVES: In this study we compared closed nailing with open nailing in fractures of middle third of clavicle to assess if the former holds any advantage.

MATERIAL AND METHODS: 34 patients with closed nailing were compared to 31 patients with open nailing in terms of operative time, length of incision, pain, time to union and functional outcome.

RESULTS: Only operative time and length of incision were significantly more in open group than in closed group.

DISCUSSION: We believe that closed reduction can be attempted in all patients undergoing nailing for middle third clavicle fracture but surgeon should have a low threshold to open the fracture if closed reduction fails as functional outcome and time to union remains unaffected.