The Journal of Bone and Joint Surgery (American). 2009;91:2746.
doi:10.2106/JBJS.9111.ebo443
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Evidence-Based Orthopaedics

Elastic Stable Intramedullary Nailing Was Effective in Displaced Midshaft Clavicular Fractures

Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS. Elastic Stable Intramedullary Nailing Versus Nonoperative Treatment of Displaced Midshaft Clavicular Fractures—A Randomized, Controlled, Clinical Trial. J Orthop Trauma. 2009 Feb;23:106-12.[CrossRef][Medline]

The first 150 words of the full text of this article appear below.

Question: In patients with fully displaced midshaft clavicular fractures, how does elastic stable intramedullary nailing (ESIN) compare with nonoperative treatment?

Design: Randomized (allocation concealed)*, unblinded controlled trial with 2-year follow-up.

Setting: Emergency department of a university hospital in Innsbruck, Austria.

Patients: 68 patients between 18 and 65 years of age with a unilateral displaced midshaft clavicular fracture with no cortical contact between the main fragments. Exclusion criteria included fractures of the medial or lateral third of the clavicle, former injuries or additional pathological conditions affecting the function of the upper extremity, concomitant injuries, pathological or open fractures, fractures with an associated neurovascular injury, and contraindication for surgery with general anesthesia. 60 patients (88%) (mean age, 38 y; 87% men) completed the study.

Intervention: Patients were allocated to receive ESIN (n = 30) or nonoperative treatment (n = 30). Patients in the ESIN group underwent surgery with general . . . [Full Text of this Article]

Michael McKee, MD

St. Michael's Hospital, Toronto, Ontario, Canada


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