Clavicle fractures comprise 40 percent of shoulder girdle fractures and 10 percent of all fractures. Most clavicle fractures appear in young, athletic patients. Research shows that the Rockwood Clavicle Pin, a device for assisting the proper healing of a broken clavicle, has advantages and disadvantages for treating clavicle fractures.
Where and what is the clavicle? The clavicle bone sits at the base of the neck and extends across the upper part of the rib cage. It is between the shoulder blade and the breastbone, and it connects the pectoral (shoulder girdle) to the axial skeleton, which forms the body's central axis.
Most commonly, clavicle fractures occur because a person falls on their shoulder. During sports, they often happen when a player receives a direct blow to the shoulder. They also can occur when the newborn passes through the birth canal. Finally, they result from trauma, for example, in vehicle accidents. Regardless of their cause, these types of fractures can cause bruising, throbbing pain, swelling, deformity, and the inability to move the shoulders.
Traditionally, physicians have used non-operative strategies for treating clavicle fractures. However, these treatments come with risks, including the patient experiencing chronic pain, weakness, and the fracture not closing (the nonunion rate).
Implanting the Rockwood Clavicle Pin has become another treatment option for clavicle fractures. The pin is a slender rod with a screw, and physicians implant it in the clavicle's intramedullary canal by making a tiny incision over the fracture site. Because of its size, the pin reduces difficulties related to implanting large devices and removing them, and it does not require substantial soft tissue dissection.
After the pin implantation, the patient should not bear any weight on the area for eight to 12 weeks or until there is evidence that the fractured area has healed. The patient also should limit extending their arms beyond 90 degrees, or above their shoulders, for six weeks. Once the clavicle is considered healed, the physician removes the pin, usually between weeks 10 and 12, under general anesthesia or in an outpatient or clinical setting.
Using the Rockwood Clavicle Pin for clavicle fractures offers physicians and patients several advantages. Compared to other procedures, the pin requires less tissue stripping, which preserves the periosteal blood supply, referring to the periosteum, a membranous tissue that covers bone surfaces. For instance, one procedure implants plates and screws along the clavicle and involves significant tissue stripping, and this can compromise the blood supply along the periosteum.
Another advantage is that the pin requires a smaller incision to implant compared with implanting a plate on the clavicle. With a smaller incision, the area heals faster and there is less scarring. Furthermore, the patient experiences less numbness from skin nerve injury.
When the physician removes the pin from the clavicle, the patient has no other devices implanted in the area. Using a plate and screws involves repositioning the bone and then holding it in place with a metal plate and screws. When the bone heals, the physician removes the plate. With the plate, the number of areas of weakness along the clavicle, or stress risers, is double because the procedure requires drilling two holes versus the Rockwood pin, which requires just one.
Other advantages are that the Rockwood Clavicle Pin procedure results in the surgical site healing much faster than when using plate fixation because the incision is smaller than that required to implant a plate. Finally, biomechanical research (study of how the body moves) shows that the Rockwood Clavicle Pin results in less rotational stiffness than plate fixation after healing.
While the Rockwood Pin offers several advantages, it has disadvantages. The first disadvantage is that the Rockwood Pin is a weaker fixation device initially than the plate fixation device. Also, the procedure requires the patient to undergo two procedures, the first to implant the device and the second to remove it. Even though it requires two procedures, the Rockwood Pin offers patients the advantage of a faster recovery time compared to the plate procedure.
Zimmer Biomet manufactures the Rockwood Clavicle Pin. For more information on this product, please visit www.zimmerbiomet.com/en/about-us/our-impact.html.
