Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

BackgroundIntramedullary nailing for fractures of middle third clavicle has become increasingly popular. Though open nailing has been widely described, closed nailing finds less mention.ObjectivesIn this study we compared closed nailing with open nailing in fractures of middle third of clavicle to assess if the former holds any advantage.Material and methods34 patients with closed nailing were compared to 31 patients with open nailing in terms of operative time, length of incision, pain, time to union and functional outcome.ResultsOnly operative time and length of incision were significantly more in open group than in closed group.DiscussionWe believe that closed reduction can be attempted in all patients undergoing nailing for middle third clavicle fracture but surgeon should have a low threshold to open the fracture if closed reduction fails as functional outcome and time to union remains unaffected.