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| Effect of titanium elastic nail in treatment of displaced midshaft clavicle fractures in older children |
| REN Jinke JIA Zhaofeng HU Xinjia |
| Department of Osteoarthropathy, Shenzhen People’s Hospital the Second Clinical Medical College of Ji’nan University the First Affiliated Hospital of Southern University of Science and Technology, Guangdong Province, Shenzhen 518020, China |
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Abstract Objective To investigate the effect of titanium elastic nail (TEN) in the treatment of displaced midshaft clavicle fractures in older children. Methods The clinical data of 47 children with displaced midshaft clavicle fractures who were treated and followed up in Department of Osteoarthropathy, Shenzhen People’s Hospital, Guangdong Province from March 2016 to July 2019 were retrospectively analyzed. According to the different treatment methods, the children were divided into two groups: the conservative group (26 cases), which received conservative treatment with transverse “8” bandage fixation; and the surgery group (21 cases), which received small incision assisted reduction and TEN fixation treatment. The children was followed up regularly in the outpatient department, and X-ray films was reexamined to evaluate fracture displacement and healing. Visual analogue scale (VAS) and Constant-Murley shoulder function score were used to evaluate the pain degree and shoulder function of the children. Results No fracture complications occurred in both groups, and regular reexamination of X-ray films showed that fractures in both groups had achieved bone healing. There were significant differences in VAS between groups, time point comparison and interaction between the two groups (all P ＜ 0.05). Comparison within the two groups: the VAS after treatment were lower in both groups than before, and the VAS at each time point after treatment were lower than before, and the differences were statistically significant (all P ＜ 0.05). Comparison between groups: VAS in the surgery group were lower than those in the conservative group one and two months after treatment, and the differences were statistically significant (all P ＜ 0.05). There were statistically significant differences in Constant-Murley shoulder function assessment between groups, time point comparison and interaction between the two groups (all P ＜ 0.05). Comparison within the two groups: Constant-Murley shoulder function score after treatment was higher in both groups than before treatment, and the differences were statistically significant (all P ＜ 0.05). Comparison between groups: one, two and three months after treatment, Constant-Murley shoulder function scores in the surgery group were higher than those in the conservative group, and the differences were statistically significant (all P ＜ 0.05). Conclusion TEN is a safe, reliable and satisfactory treatment for displaced midshaft clavicle fractures in older children. Compared with conservative treatment, TEN can relieve pain and recover function faster.
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