Displaced mid-shaft clavicular fractures: surgical treatment with intramedullary screw fixation

Clavicle fractures account for around 4 % of all fractures and up to 44 % of fractures of the shoulder girdle. Fractures of the middle third account for approximately 80 % of all clavicle fractures. Management of mid-shaft clavicular fractures is often challenging and the outcome can be unsatisfactory. We prospectively evaluated 20 patients (16 males and 4 females) with an average age of 31 years (range 18-50 years) presented with fresh mid-shaft clavicular fractures who underwent open intramedullary fixation using a 6.5 partially threaded cancellous screw. The screw was inserted from the lateral fragment after retrograde drilling of that fragment. Average follow-up period was 16 months (range 10-24). All cases united within 7-9 weeks (mean 8.2). Superficial infection was observed in one patient, three experienced decreased sensation over the site of incision, and four had symptoms of frozen shoulder. The technique is safe, simple, reliable method for fixation of displaced mid-shaft clavicle fractures with minimal complications and excellent functional outcomes. No complaints or indications for hardware removal after fractures healing.