![]() Recently, intramedullary fixation has gained increased interest. Traditionally, operative treatment has been achieved by using a plate and screws. Still, surgical treatment is gaining popularity among surgeons for adolescents who require early functional recovery and have a high activity level. The absolute indications for surgery in adolescents are an open clavicle fracture, a floating shoulder, and associated neurovascular injuries. ![]() There is a debate about surgical intervention in clavicle fractures in adolescents, as these fractures heal fast and have great remodeling potential. ![]() However, the management of displaced midshaft clavicle fractures in adolescents remains poorly investigated. In adults, there has been an increasing trend for operative interventions, as they have been reported to give better functional outcomes. ![]() The midshaft is the most commonly involved anatomical location. Level of evidenceĬlavicle fracture is one of the most common fractures in the pediatric population and accounts for about 10–15% of all fractures. The ESIN is superior to the plate given its shorter operative time, shorter hospital stay, lower rate of scar concern, and easier implant removal. Both the ESIN and the plate are safe and effective treatment methods for displaced midshaft clavicle fractures in adolescents. ConclusionĪ conservative approach remains the first choice for a pediatric clavicle fracture. There was no statistically significant difference in shoulder function between the ESIN group and the plate group at different time points. The rate of scar concern was much higher in the plate group (71.4%) than the ESIN group (22.2%) ( P < .001). 5.4 cm) as compared to the plate group ( P < .001). 2.5 days), and a smaller incision (2.4 vs. 59.8 min), a shorter hospital stay (1.5 vs. The ESIN group presented significantly less operative time (31.1 vs. 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. 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. ResultsĪ total of 73 patients were included. The scar problem was evaluated according to the Scar Cosmesis Assessment and Rating (SCAR) scale. Clinical outcome was evaluated during outpatient visits using the American Shoulder and Elbow Surgeons (ASES) score. The postoperative data, including clinical outcome and complications, were collected during the follow-up visits. The preoperative data, including baseline information on the patients, and types of surgical procedure were collected from the hospital database. MethodsĪll 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. This study aims to compare the clinical outcomes of adolescent patients who were operated on with an ESIN vs. However, a minimally invasive trend has led surgeons to use the elastic stable intramedullary nail (ESIN) for displaced midshaft clavicle fractures. If those don't work, you may need surgery.Traditionally, operative treatment for displaced midshaft clavicle fractures in adolescents has been achieved by using a plate and screws. Other treatments include exercise and medicines to reduce pain and swelling. This stands for Rest, Ice, Compression, and Elevation. Often, the first treatment for shoulder problems is RICE. Health care providers diagnose shoulder problems by using your medical history, a physical exam, and imaging tests. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons, and ligaments.īecause your shoulder can be unstable, it can be easily injured. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. Your shoulders are the most movable joints in your body. Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone).
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