Operative treatment of midclavicular fractures in 62 elderly patients: knowles pin versus plate.

This prospective, randomized trial compared treatment with Knowles pins and plates in 62 elderly patients (>50 years) with midclavicular fractures. The clinical outcomes were evaluated at 30 months postoperatively. The mean shoulder score of the Knowles pinning was 85 points and the plating was 84 points (P=.7). Knowles pinning requires significantly shorter operative time (P<.001), smaller wound size (P<.001), shorter hospital stay P=.03), less meperidine use (P=.02), lower complication rate (P=0.04), and less symptomatic hardware (P=.015). If surgery of mid-third clavicular fractures is indicated, fixation with a Knowles pin has more advantages than plate fixation in elderly patients.