Minimally Invasive Intramedullary Fixation of Middle third clavicular Fractures Through the Medial Entry by Titanium Elastic Nailing System (TENS)

Bin Muslem, Ahmed Mohsen Salem; Mostafa, Ibrahim Ahmed; El Sawy, Gamal Attia

doi:https://doi.org/10.21608/aimj.2025.446639

Minimally Invasive Intramedullary Fixation of Middle third clavicular Fractures Through the Medial Entry by Titanium Elastic Nailing System (TENS)

Document Type : Original Article

Authors

¹ MBBCh, Faculty of Medicine, Assiut University, Assiut, Egypt

² Professor of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

³ Lecturer of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446639

Abstract

Background: It is routine practice in sports medicine to treat injuries to the anterior cruciate ligament(ACL). Athletes and regular people alike are prone to this form of damage when they engage in incorrect fitness or workout routines.
Aim and objectives: To determine the long-term success rate of anterior cruciate ligament repair(ACLR) using various graft types.
Subjects and methods: Between 2010-2023, we used the following keywords to search the MEDLINE database through PubMed, EMBASE, and the Cochrane Library:ACL restoration, quadriceps tendon grafts, hamstring-tendon autografts, bone patellar tendon(BPT) autografts, peroneus longus autografts, semitendinosus tendon, and gracilis tendon autografts are all examples of tendon transplants.
Results: Peroneus longus tendon(PLT) grafts were harvested from various sites, while HT grafts typically included semitendinosus and occasionally gracilis tendons. Various methods were employed, including single-bundle(anatomic and primary) and double-bundle techniques, with attention to fixation methods(e.g., press-fit fixation for HT and interference screw fixation for quadrupled HT). Complications varied, with knee stiffness reported in 20% of HT vs. 5% of PLT patients in one study. Graft ruptures occurred more frequently in the HT group(four instances) than in the PLT group(two instances). Other complications included minor wound issues and infections.
Conclusion: Both HT and PLT grafts resulted in significant improvements in knee function as measured by International Knee Documentation Committee(IKDC), Lysholm, and modified Cincinnati scores, with no significant difference in outcomes between graft types. Complications such as graft rupture, knee stiffness, infections, and graft failure were reported across studies, but the overall rate of complications did not differ significantly between the graft types.

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