{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:00:40Z","timestamp":1781650840856,"version":"3.54.5"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["jocr"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>Introduction: Midshaft clavicle fractures are common, with comminuted variants posing a higher risk of non-union, often necessitating surgical intervention. Anatomical repair is critical due to the clavicle\u2019s sole osseous connection between the shoulder and trunk, impacting functional outcomes.\n\nCase Series: This retrospective study evaluated 83 patients (74 males, nine females, aged 18\u201365 years) surgically treated for midshaft clavicle fractures (2010\u20132023). Dominant-side fractures accounted for 87% of cases. Severe comminution was managed using 2.7 mm cortical interfragmentary screws and the NISE knot technique with plating. Follow-up spanned 18 months, assessing clinical and radiological outcomes. Patients regained near-complete shoulder motion within 3 weeks. Complications included visible deformity (n = 4), keloid formation (n = 3), scar hypoesthesia (n = 5), and one refracture with plate failure. No non-unions occurred, though two cases exhibited delayed union. Radiological and functional recovery was achieved in 97.6% of cases, with minimal long-term sequelae.\n\nConclusion: Surgical fixation of 3- or 4-part comminuted midshaft clavicle fractures using plate and screws demonstrates high union rates, rapid functional recovery, and low complication rates. This approach is recommended for complex fractures, as non-operative management risks non-union, malunion, and functional deficits.\n\nKeywords: clavicle fractures, midshaft clavicle fractures, comminuted fractures, Surgical fixation, suture techniques (including NISE knot technique), interfragmentary screws, anatomical plates, functional outcomes, union rates, oxford shoulder score.<\/jats:p>","DOI":"10.13107\/jocr.2025.v15.i07.5836","type":"journal-article","created":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T09:44:53Z","timestamp":1751795093000},"page":"237-241","source":"Crossref","is-referenced-by-count":2,"title":["Management of Comminuted Midshaft Clavicle Fractures with Interfragmentary Screws, Non-Invasive Screw Fixation Knot Technique and Plating in 83 Patients"],"prefix":"10.13107","volume":"15","author":[{"name":"Department of Orthopaedic, JN Medical College and KAHER University, Belgavi, Karnataka, India,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahil","family":"Kale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Kale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedic, JN Medical College and KAHER University, Belgavi, Karnataka, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omkar","family":"Kerkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedic, JN Medical College and KAHER University, Belgavi, Karnataka, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya","family":"Botta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedic, JN Medical College and KAHER University, Belgavi, Karnataka, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Vatkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"[2] Department of Orthopaedics, Spine Surgery Unit, Fortis Hiranandani Hospital, Vashi, Navi Mumbai, Maharashtra, India, [3] Department of Orthopaedics, MGM Medical College, Nerul, Navi Mumbai, Maharashtra, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Kale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Nerul, Navi Mumbai, Maharashtra, India.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2025]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T09:44:55Z","timestamp":1751795095000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2025\/07\/01\/management-of-comminuted-midshaft-clavicle-fractures-with-interfragmentary-screws-non-invasive-screw-fixation-knot-technique-and-plating-in-83-patients\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025]]},"published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2025.v15.i07.5836","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}