Zhang Junwei, Nie Weizhi, Bi Hongzheng, Hou Jinyong, Li Zhaohui, Ma Zhenyuan, Duan Laibao, Chen Lingling, Zhang Peng, Jiang Hongjiang
Department of Orthopedics, Shandong Wendeng Osteopathic Hospital, Weihai, Shandong, China.
Shenzhen Institute of Advanced Technology Chinese Academy of Sciences, Shenzhen, Guangdong, China.
Sci Rep. 2025 Apr 7;15(1):11870. doi: 10.1038/s41598-025-95975-y.
To investigate the three-dimensional displacement of midshaft clavicular fractures after closed reduction and fixation with titanium elastic intramedullary nails. From January 2019 to January 2023, 74 patients with midshaft clavicle fractures (classified according to the AO/OTA system as groups A, B, and C) underwent closed reduction and titanium elastic nail fixation. Preoperative bilateral clavicular CT data and postoperative CT data of the affected clavicle were recorded and processed using Mimics software. Clavicle length, clavicle shortening, separation, and rotational displacement along the X/Y/Z axes were measured and recorded. Within-group comparisons showed a significant reduction in clavicle shortening and separation displacements, with a notable restoration of clavicle length postoperatively (p < 0.05). Except for Z-axis rotational displacement in Group A, no significant differences were observed in clavicle rotational displacement along the X/Y/Z axes between preoperative and postoperative measurements (p > 0.05). Between-group comparisons showed that preoperative separation displacement was significantly associated with AO/OTA classification (H = 6.427, p = 0.040), while no significant differences were observed in other displacements between preoperative and postoperative measurements across groups. Titanium elastic intramedullary nails effectively restore clavicular length and correct shortening and separation displacement in midshaft fractures, but do not significantly improve rotational displacement along the X/Y/Z axes.
探讨闭合复位钛弹性髓内钉固定后锁骨中段骨折的三维位移情况。2019年1月至2023年1月，74例锁骨中段骨折患者（根据AO/OTA系统分为A、B、C组）接受了闭合复位和钛弹性钉固定。记录术前双侧锁骨CT数据及术后患侧锁骨CT数据，并使用Mimics软件进行处理。测量并记录锁骨长度、锁骨缩短、分离以及沿X/Y/Z轴的旋转位移。组内比较显示，锁骨缩短和分离位移显著减小，术后锁骨长度明显恢复（p < 0.05）。除A组Z轴旋转位移外，术前与术后测量的锁骨沿X/Y/Z轴的旋转位移无显著差异（p > 0.05）。组间比较显示，术前分离位移与AO/OTA分类显著相关（H = 6.427，p = 0.040），而各组术前与术后测量的其他位移无显著差异。钛弹性髓内钉可有效恢复锁骨中段骨折的长度，纠正缩短和分离位移，但对沿X/Y/Z轴的旋转位移改善不明显。
