Efficacy of Intramedullary Bridge Internal Fixation System for Midshaft Clavicle Fractures: A Novel Technique for Clavicle Treatment

Abstract

Abstract Objective: The intramedullary nail fixation approach currently used for midshaft clavicle fractures is associated with complications, including nail loosening and displacement, nail end protrusion and soft tissue irritation. In this study, we propose a novel intramedullary fixation technique using the ortho-bridge system (OBS) to improve clinical outcomes and avoid the issues linked with treating midshaft clavicle fractures. Methods: Sixty-three patients with midshaft clavicle fractures were randomly categorized into a control group (n = 35) and an observation group (n = 28). The control group received internal fixation with a locking plate, while the observation group underwent OBS intramedullary fixation. Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of internal fixation, visual analog scale (VAS) for shoulder pain, Constant Shoulder Score and complication occurrence were compared between the two groups. Results: In preoperative general data, such as sex, age and fracture types were not significantly different between the two groups (P > 0.05). However, the observation group showed better outcomes than the control group in terms of surgical time, intraoperative blood loss and total incision length (P< 0.05). Additionally, the observation group exhibited significantly shorter fracture healing time and internal fixation removal time than the control group (P < 0.05). VAS scores at postoperative day 1, week 1, month 1 and month 3 were lower in the observation group than in the control group (P< 0.05).Furthermore, the observation group had higher Constant Shoulder Scores at 1, 3,and 6 months than the control group (P < 0.05), with no significant difference at 1 year postoperatively (P > 0.05). Lastly, complication incidence in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: The study revealed that compared to locking plate internal fixation for midshaft clavicle fractures, OBS intramedullary fixation offers advantages, including reduced surgical trauma, lesser postoperative pain, faster fracture healing, earlier shoulder joint function recovery and fewer complications. Additionally, this approach provides better aesthetic outcomes and comfort in the surgical area. Therefore, this technique may have potential clinical application as a novel treatment for midshaft clavicle fractures.