Observational studyJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2022
Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures.
Observational study in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Elastic intramedullary nailing: a viable solution to stabilise adult humeral diaphyseal fractures? A systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Midshaft clavicular fractures in adolescents: a comprehensive review of diagnosis and management.Clinics in shoulder and elbow · 2025Review
- Operative Treatment of Adolescent Diaphyseal Clavicle Fracture: Elastic Stable Intramedullary Nail Versus Plate Fixation.Medicina (Kaunas, Lithuania) · 2025Article
- Elastic stable intramedullary nailing (ESIN) for displaced midshaft clavicle fractures in adolescents (12-18 Years): a study of early functional outcomes and safety.Journal of orthopaedic surgery and research · 2025Article
- Finite element analysis of antegrade and retrograde internal intramedullary nailing for mid-shaft clavicle fracture.BMC musculoskeletal disorders · 2025Article
- Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- A Rare Combined Injury in Children during Side Impact: The Possible Mechanism and Treatment Results.Orthopaedic surgery · 2024Article
- Robot-Assisted Retrograde Elastic Intramedullary Nailing Versus ORIF with a Plate for Displaced Midshaft Clavicular Fractures.JB & JS open accessArticle
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTraditionally, operative treatment for displaced midshaft clavicle fractures in adolescents has been achieved by using a plate and screws. However, a minimally invasive trend has led surgeons to use the elastic stable intramedullary nail (ESIN) for displaced midshaft clavicle fractures. This study aims to compare the clinical outcomes of adolescent patients who were operated on with an ESIN vs. a plate.
methodsAll patients aged between 10 and 14 years with displaced midshaft clavicle fractures who were operated on at our institute between January 2014 and January 2018 were reviewed retrospectively. The preoperative data, including baseline information on the patients, and types of surgical procedure were collected from the hospital database. The postoperative data, including clinical outcome and complications, were collected during the follow-up visits. Clinical outcome was evaluated during outpatient visits using the American Shoulder and Elbow Surgeons (ASES) score. The scar problem was evaluated according to the Scar Cosmesis Assessment and Rating (SCAR) scale.
resultsA total of 73 patients were included. Patients were categorized into two groups: ESIN (n = 45; 27 males, 18 females) and plate (n = 28; 17 males, 11 females), according to surgical technique. The average age of the patients in the ESIN group was 12.2 ± 1.5 years, and that in the plate group was 12.2 ± 1.4 years. The ESIN group presented significantly less operative time (31.1 vs. 59.8 min), a shorter hospital stay (1.5 vs. 2.5 days), and a smaller incision (2.4 vs. 5.4 cm) as compared to the plate group (P < .001). The rate of scar concern was much higher in the plate group (71.4%) than the ESIN group (22.2%) (P < .001). There was no statistically significant difference in shoulder function between the ESIN group and the plate group at different time points.
conclusionA conservative approach remains the first choice for a pediatric clavicle fracture. Both the ESIN and the plate are safe and effective treatment methods for displaced midshaft clavicle fractures in adolescents. The ESIN is superior to the plate given its shorter operative time, shorter hospital stay, lower rate of scar concern, and easier implant removal. LEVEL OF EVIDENCE: III, retrospective observational study.
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