The Treatment of Fractures of the Mid-third clavicule using a Cannulated Screw

Abstract

We have been conducting internal fixations for a fracture of the mid-third clavicule. It is possible with this method to prevent a malunion and return to work early. We have used a cannulated screw because of its tight fixation and small incision. The type of screw initially used caused subcutaneus pain and there was a cancellous thread. Therefore we produced a second type of screw with a round tip and cortical thread. We wish to report on the good results we acquired with this devise.
The subjects of this study were those cases which had contacted two fragm ents after a reduction. We applied this method on 25 patients (21 males and 4 females). Their ages ranged between 16 and 38years old. We developed the cannulated screw with Best Medical Co. Ltd. The initial type screw size had an outer diameter of 5.0mm thread, a shaft diameter of 4.0mm and the width of the thread was 1.75mm. The second type of screw had an outer diameter of 5.0mm thread, a shaft diameter of 4.0mm and the width of the thread was 1.0mm. We inserted a screw from the distal clavicula and obtained a tight fixation with the proximal cortical bone.
The amount of bleeding was 50g on av erage. The operation time was 36 minutes on average. The length of the screw ranged from 80mm to 110mm. All the cases had a bone union. None of the cases had a limit of ROM, trouble of ADL or infection. But a screw was broken in one case.
The advantages of an internal fixation using a cannulated screw are that it is a tight fixation, a small incision, an easy extraction and an easy operation. We believe that this method is useful for fracture of the mid-third clavicula.