• K Witzel.
• New European Surgical Academy, Berlin. kai@witzel-chirurgie.de
• Z Orthop Unfall. 2007 Sep 1; 145 (5): 639-42.

AimIn Germany, non-operative treatment using a figure of eight dressing is the most common method for managing fractures of the mid-third of the clavicle. This treatment is chosen preferably even in cases of dislocated fractures. The described procedures of open osteosynthesis are characterised by a huge access trauma. Up to date literature shows the advantages of intramedullary pin osteosynthesis, which can be considered as a minimally invasive procedure. In this study we compare the results of pin-osteosynthesis with the non-operative treatment in athletes.MethodsThis prospective randomised trial compares the results of 68 athletes with an isolated fracture of the middle third of the clavicle. One group (n=35) received intramedullary splints, the other group (n=33) had a figure of eight dressing instead.ResultsPost-traumatic pain was significantly (p=0.05) lower in the group that had intramedullary splints. Furthermore, the postoperative mobility of the injured area was significantly better (p=0.05). Measurements of the strength of the injured side 120 days after the trauma show a significant (p=0.01) advantage of the pin osteosynthesis.ConclusionThe intramedullary titanium pin osteosynthesis is a promising alternative with better results. Up to date literature and our own results prove the advantages of this minimally invasive osteosynthesis. This procedure allows sports activities to be resumed soon after the operation. As intramedullary pin osteosynthesis is an ideal operation of fractures of the middle third of the clavicle, this comparatively easy procedure with few complications should be more widespread.

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