Assessment of elastic nail for fracture treatment among the Nigerian Patients
Abstract
Clavicle fractures are commonly treated through conservative methods. However, due to a higher likelihood of complications such as delayed union, non-union, symptomatic malunion, cosmetic deformities, and other issues, surgical intervention has become more widely used. Plating and intramedullary nailing are among the most frequently employed surgical techniques. Recent prospective randomized studies have shown that operative treatment often yields better outcomes than traditional methods. This study aims to compare clinical outcomes, surgical techniques, and associated complications. A total of 50 patients with OTA type B displaced midshaft clavicle fractures (DMCFs) underwent surgical fixation using either antegrade Titanium Elastic Nails (TENS) or a one-third tubular plate. The patients were divided into two groups based on the fixation method. Their outcomes were assessed using the Constant-Murley shoulder score and DASH score at 6 weeks, 12 weeks, 3 months, 6 months, and 12 months postoperatively. Findings indicated that the TENS group experienced easier implant removal, minimal complications, reduced blood loss, and shorter operating time. The primary complication observed in this group was slight shortening (approximately 0.5 cm) in a few cases. In contrast, the plate fixation group did not exhibit major complications, though minor issues such as deep and superficial infections, hypertrophic scarring (without pain), and mild shoulder motion restriction were noted. However, no cases of shortening were reported in this group. Both fixation methods demonstrated similar outcomes in terms of bone union and stability. However, TENS appeared to be the preferred choice due to its lower morbidity, improved cosmetic results, and ease of implant removal. Plate fixation, on the other hand, offered slightly greater stability and was preferred in cases of comminuted fractures.
Keywords: Titanium Elastic Nail, Tubular Plate, Displaced Midclavicular Fracture.
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