European Journal of Molecular & Clinical Medicine

Abstract

Background:Clavicle fractures are common fractures, comprising 5% to 10% of all fractures
seen in emergency departments. Fractures of the middle third, or midshaft, are the most
common, accounting for up to 80% of all clavicle fractures. They occur due to falls on the
lateral aspect of the shoulder, the outstretched hand or due to high-energy direct impact over
the bone. The incidence of clavicle fractures has increased in recent years and the operative
treatment of these fractures has increased disproportionately. Clavicle fractures are most
commonly classified according to the Allman classification and the Robinson classification. The
location and type of fracture are important in decision-making as it influences management
strategies. The clavicle acts as the only osseous link between the upper extremity skeleton and
the thorax. In animals that do not bear weight on their forelimbs, it is absent. In such animals,
the scapula is stabilized to the thorax by numerous powerful muscles. The absence of a clavicle
improves running and agility on four limbs. In brachiating animals however, including man, it
serves as a solid strut to position the upper limb away from the trunk and enhance more global
positioning and use of the limb. Intramedullary fixation is often preferred over plate fixation
because it is a simpler procedure. Intramedullary fixation has a smaller surgical incision, less
invasive, easier hardware removal, and shorter hospital stay. Various devices can be used with
this surgical option including Knowles pins, Hagie pins, Rockwood pins, and minimally
invasive titanium nails. Devices need to be very flexible; the implant needs to be very stable, and
it must be small enough to pass through the medullary space at its most narrow point in the
midclavicle.