Kirschner Wire Temporary Intramedullary Fixation Combined with a Locking Anatomical Plate versus a Reconstruction Plate in the Treatment of Comminuted Clavicular Fractures: A Retrospective Study

We investigate the clinical efficacy of Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate for the treatment of comminuted clavicular fractures. We retrospectively studied 112 patients [80 (71%) men] treated between February 2007 and February 2014. The patients were allocated to treatment with Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate [minimally invasive group (G(M))] or a reconstruction plate [traditional group (G(T))]. The 112 patients were followed up for 12–48 months (mean, 14 months). The operation time was significantly shorter in G(M) than in G(T). Intraoperative blood loss was significantly less in G(M) than in G(T). The total incision length was significantly shorter and the visual analog scale pain score 24 h after surgery was significantly lower in G(M) than in G(T). Fracture healing time was significantly shorter and the complication rate was significantly lower in G(M) than in G(T). No significant difference in shoulder function score was observed between groups. We recommend Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate as the treatment of choice for comminuted clavicular fractures because of the shorter operation time, lesser intraoperative blood loss, easier reduction of the operation, quicker fracture healing, and lower postoperative complication rate.