Intramedullary nailing of displaced midshaft clavicle fractures using a TEN with end cap: issues encountered

Keywords:

Intramedullary ; nailing ; TEN ; end cap ; complication ; clavicle.


Published online: Dec 30 2018

Martijn Hulsmans, Mark van Heijl, Roderick Houwert, Egbert Jan Verleisdonk, Herman Frima

From the Diakonessenhuis, Nederland

Abstract

The purpose of this study was to describe our experience with a possible solution for implant-related irritation after intramedullary nailing of displaced midshaft clavicle fractures: the end cap.

Ten patients with a displaced midshaft clavicle fracture were treated with intramedullary nailing and an end cap in 2013. Patients were followed in the outpatient clinic until fracture union. In 2015 patients were contacted again. Prospectively collected data included shoulder function and complications.

The median follow-up time was 28.5 months (between 27 and 30 months). No patients were lost to follow-up. QuickDASH scores were 18.2, 9.1 and 2.3 after 6 weeks, 3 month and latest follow-up respectively. Nine patients (90%) had some type of implant-related complication. In three of these patients implant removal was required before union. One implant failure occurred which required major revision surgery using plate fixation.

In conclusion, because in 70% of the patients the implant-related irritation was directly caused by the end cap, we believe end caps should not be used after intramedullary nailing for displaced midshaft clavicle fractures.

About this issue

Volume 84, issue 4.

Dec 2018.

 

Open access journal

This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.