[Translated article] Comparative analysis between intramedullary screw fixation and plate osteosynthesis in midshaft clavicle fractures: surgical efficiency and functional outcomes in contact athletes.

Abstract

Background:  Plate fixation is the current gold standard for displaced midshaft clavicle fractures, despite concerns regarding surgical morbidity and implant prominence. The purpose of this study was to compare the clinical, radiographic, and surgical outcomes of an intramedullary screw system versus conventional plate fixation.

Methods:  A comparative cohort study was performed on 72 patients (36 treated with the Screw system and 36 with plate fixation). Surgical variables (time and blood loss), radiographic consolidation (at 4, 8, and 12 weeks), and functional outcomes (DASH and Constant-Murley scores) were analyzed. Statistical significance was set at p < .05.

Results:  The Screw group demonstrated a significantly shorter operative time (27.69+/- 9.39 vs. 105.47 +/- 55.18 minutes; p<.001) and minimal blood loss (10 vs. 228.33 ml; p<.001). Functional recovery was significantly faster in the DualTrack group, with an earlier return to physical activity (6.64 vs. 21.69 weeks; p<.001) and superior Constant scores (98.64 vs. 94.81; p = .0006). Radiographically, the screw group showed significantly lower fracture line visibility at 8 and 12 weeks compared to the plate group (p<.05). Complication rates were lower for the screw group (8.3%) than for the plate group (25.0%), although this did not reach statistical significance (p=.11).

Conclusion:  The intramedullary system is a highly effective alternative for clavicle fractures, providing superior surgical efficiency, faster functional recovery, and improved biological healing compared to conventional plate fixation. It should be considered a primary treatment option, particularly for patients seeking a rapid return to activity and minimally invasive surgery.