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Online Exclusive, Original Study

Outcome of Intramedullary Fixation of Clavicular Fractures

We conducted a retrospective, single-center (tertiary referral center with associated level I trauma cen­ter) review to evaluate the outcome of open reduc­tion and internal fixation (ORIF) with intramedullary (IM) clavicle pin of displaced clavicular fractures.

Sixty-eight displaced midshaft clavicle fractures in 68 patients underwent ORIF with IM clavicle pins. Patients were identified through a perioperative data­base by searching for Current Procedural Terminology (CPT) codes. Union was the primary outcome. Secondary outcomes included time to union, pain, incidence of nonunion and delayed union, postop­erative range of motion, and incidence of complications.

Sixty-six fractures (97%) went on to union. Complications included painful hardware (44%), deep and superficial wound infections (10%), and hardware failure (4%), including pin breakage and extrusion. Postoperative shoulder pain was present in 10% of patients and limited shoulder range of motion in 12%. IM pin fixation can pro­vide good outcomes, even for fractures with a significant amount of shortening and comminution.

Am J Orthop. 2011;40(6):E99-E104.

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