According to recently published results, precontoured locked plates and flexible, locked intramedullary nails were both effective in the management of displaced or shortened clavicular fractures.
Researchers identified 72 patients with acute displaced and/or clavicular shaft fractures. Thirty-seven patients were randomly assigned to be managed with an anatomically contoured locked plate and 35 patients were managed with a Sonoma CRx flexible, locked intramedullary nail (Sonoma Orthopedic Products). Investigators recorded incision length, surgical time and union rate. The DASH and Constant Shoulder scores were used to assess the functional outcomes of the shoulder.
Results showed no differences in patient characteristics, fracture type or displacement between the treatment groups. The surgical time was significantly better in patients treated with a locked plate compared with the flexible, locked intramedullary nail (45 vs. 65 minutes). The incision size was also significantly shorter in patients treated with the locked plate compared with patients treated with the flexible, locked intramedullary nail (37 mm vs. 116 mm). Investigators noted both groups had a 100% union rate. Both treatment groups had similar DASH scores at 1.5, 3 and 6 months. However at 12 months, the nailing group had significantly better DASH scores. The difference only had a moderate effect size, according to researchers.
Patients treated with locked plates had substantially greater individual variation in DASH and Constant Shoulder scores than the nail group. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.