Titanium elastic nails system (TENS) fixation in midshaft clavicular fractures – A prospective study

Introduction: The clavicle is most frequently and easily fractured bone, due to direct blow or fall on the outstretched hand. With changing trends in treatment of midshaft clavicle fractures, plating was one of the standard procedure remains for fixation. Recent attracting alternative new technique of fixation is the titanium elastic nailing system (TENS). Due to lacking of prospective studies, the present study was undertaken to assess effectiveness of minimally invasive method TENS for the treatment of midshaft clavicle fracture. Materials and Methods: The study population included 30 patients exclusively with fracture of midshaft clavicle on plain radiographs from January 2014 to June 2015 at a tertiary care centre. Most of cases were operated within 24-48 hours after trauma. Intra operatively, image intensifier was used for monitoring the manipulations and maneuvering of the nails for closed reductions of the fractures. Patients were followed for 6 months postoperatively and then titanium nails were removed. Result: Average age of the study population was 35.8 ± 10 yrs. Most cases were operated within 24-48 hours after trauma. In 24 cases, closed reductions and nailing were done, while in 6 cases, open reductions and nailing were done. Constant score was used to assess the clinical outcome of our patients after union of the fracture. Clinical union was achieved in 3-5 weeks, while radiographic union was achieved in 6-8 weeks. There was no post-operative infection in this study. Conclusion: Operative interventions with TENS showed better results in regards to early functional recovery. The specific advantages of TENS over plating are that it is minimally invasive, needs lesser operative time, and early mobilization.