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Title: Management of acute displaced midshaft clavicular fractures using Herbert cannulated screw: Technique and results in 114 patients.
Epworth Authors: Richardson, Martin
Other Authors: Richardson, Louise
Asadollahi, Saeed
Keywords: Epworth HealthCare Musculoskeletal Clinical Institute, Melbourne, Australia
Fracture Fixation, Internal
Internal Fixators
Fixation Devices, Internal
Fracture Fixation, Intramedullary
Intramedullary Nailing
Nailing, Intramedullary
Shoulder Fractures
Osteosynthesis, Fracture, Intramedullary
Fractures, Malunited
Orthopedic Surgery
Surgery, Orthopedic
Surveys and Questionnaires
Sports Injuries
Injuries, Sports
Herbert Screw
Cannulated Screw
Disability of the Arm, Shoulder, and Hand
American Shoulder and Elbow Surgeons Elbow
Issue Date: Jun-2013
Publisher: Wolters Kluwer - Medknow Online
Citation: Int J Shoulder Surg. 2013 Apr;7(2):52-8.
Abstract: PURPOSE: A new and simple operative technique has been developed to provide internal fixation for midshaft clavicle fractures. This involves the use of a large fragment Herbert Screw that is entirely embedded within the bone. Screw fixation is combined with bone grafting from intramedullary reamings of the fracture fragments. The purpose of this report is to assess the outcomes following treatment of midshaft clavicular fracture using this method. MATERIALS AND METHODS: One hundred and fourteen patients with acute displaced midshaft fracture were identified between 2002 and 2007. All patients were followed until fracture union. Patients' medical records were reviewed. Disability of the Arm, Shoulder, and Hand questionnaire (DASH), and American Shoulder and Elbow Surgeons Elbow form (ASES) were posted to all patients. Outcome measures included union rate, time to union, implant removal rate, DASH, and ASES scores. RESULTS: Patients' median age was 29.5 years (interquartile range, 19-44 years). The most common injury mechanism was sports injury (28%). The median time from injury to surgery was 5 days (interquartile range, 2-9 days). Union occurred in an average of 8.8 weeks. Non-union occurred in three cases (2.6%). The re-operation rate for symptomatic hardware prominence screw was 1.7%. The median DASH score was 0.83 and the median ASES was 100 (n = 35). CONCLUSIONS: Intramedullary fixation using cannulated Herbert screw can be used as an effective approach for operative management of midshaft clavicular fractures. Using this method, an appropriate outcome could be achieved and a second intervention for implant removal could be avoided in great majority of cases.
DOI: 10.4103/0973-6042.114227
PubMed URL:
ISSN: 0973-6042
Journal Title: International Journal of Shoulder Surgery
Type: Journal Article
Affiliated Organisations: Westmead Hospital, Sydney, NSW, Australia
The University of Melbourne, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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