Intramedullary nailing of dislocated midshaft clavicle fractures with the Rockwood Clavicle Pin, a retrospective study

Abstract

This retrospective study evaluated the outcome after intramedullary nailing with the Rockwood Clavicle Pin (RCP) for acute displaced middle third clavicle fractures in adults.

Of 84 included patients treated for this fracture 2003-2009, 66 (79%) were evaluated. Of these, 52 (79%) were re-examined, including fluoroscopy, while 14 patients (21%) were evaluated by mailed questionnaire. Primary outcome was Constant score (CS), secondary outcomes included : Subjective Shoulder Value (SSV), healing rate at follow up, complications, and cosmetic appearance.

Patients were re-evaluated with a mean follow-up of 39 months (range 13-96). Mean CS at follow up was 90 (range 55-100) and mean shoulder function measured with the SSV was 93 (range 36-100). Three (6%) of the re-examined patients had a non-union at follow up. Twelve (18%) had wound problems, with exposure of the lateral part of the pin in five patients (8%). There were no deep infections but seven patients (11%) were treated for superficial wound infections. Breakage of the implant occurred in one case (2%).

Treatment of displaced midshaft clavicle fractures with the RCP results in good clinical outcome and a high patient satisfaction with a high healing rate. However, the technique is associated with postoperative complications.

Level of evidence : Level IV, Case series with no comparison group. Treatment study.