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A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

Original Article | Vol 12 | Issue 1 | January-June 2026 | page: 36-43 | Sanjay Chhawra, Rahul Aggarwal, Raman Jain, Amit Gupta, Amit Nagar, Rishav Anand, Rajat Mudgal, Hritik Swarnkar DOI: https://doi.org/10.13107/ti.2026.v12.i01.86 Submitted: 21/02/2026; Reviewed: 29/03/2026; Accepted: 02/04/2026; Published: 10/04/2026 Authors: Sanjay Chhawra [1], Rahul Aggarwal [1], Raman Jain [1], Amit Gupta [1], Amit […]

Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

Review Article | Vol 12 | Issue 1 | January-June 2026 | page: 31-35 | Sachin Kale, Nilesh Kamat, Shailesh Pai, Ashok Shyam, Gaurav Sharma, Nikhil Makhija , Riddhi Shah DOI: https://doi.org/10.13107/ti.2026.v12.i01.84 Submitted: 04/03/2023; Reviewed: 27/03/2023; Accepted: 07/05/2023; Published: 10/04/2026 Authors: Sachin Kale [1], Nilesh Kamat [1], Shailesh Pai [1], Ashok Shyam [1], Gaurav Sharma […]

A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

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A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

DOI: https://doi.org/10.13107/ti.2026.v12.i01.86

Submitted: 21/02/2026; Reviewed: 29/03/2026; Accepted: 02/04/2026; Published: 10/04/2026

Authors: Sanjay Chhawra [1], Rahul Aggarwal [1], Raman Jain [1], Amit Gupta [1], Amit Nagar [1], Rishav Anand [1], Rajat Mudgal [1], Hritik Swarnkar [1]

[1] Department of Orthopaedics, Jaipur Golden Hospital, Sector 3 Rohini, New Delhi, India.

Address of Correspondence

Dr. Sanjay Chhawra,

Department of Orthopaedics, Jaipur Golden Hospital, Sector 3 Rohini, New Delhi, India.

E-mail: sanjaychhawra@yahoo.com

Abstract

Introduction: Clavicle fractures are common injuries, accounting for 5%-10% of total fractures. The middle third of the clavicle is fractured in 69% of cases, the distal third is fractured in 28% of cases, and the proximal third is fractured in 3% of cases. Early displaced midshaft clavicle fractures were treated conservatively after studies it has being defined that there is nonunion with decreased functional outcome. Surgery is indicated in the event of substantial fracture displacement and accompanying neurovascular damage. Plate osteosynthesis is the conventional approach for treating fractures requiring internal fixation with various complications. Intramedullary fixation using the titanium elastic nailing system (TENS) is becoming a more preferred method for internal fixation of displaced mid-clavicular fractures with minimal incision and better functional outcomes.

Methodology: A prospective study was undertaken with a sample size of 30 patients over two years, with all cases followed up for 12 months. A complete clinical examination of the patient was conducted to evaluate associated injury radiological assessment of the intramedullary diameter of the clavicle was also done. Following approval and clearance from the institutional ethics committee, patients who met the inclusion criteria were enrolled in the study after providing informed consent. The functional outcomes of the study included ASES, CONSTANT, and VAS.

Result: The mean operation time was 40 min, 3 days after surgery the VAS score was 2-3, Union in weeks mean was 10 weeks and functional score after 12 months ASES Score 3 cases of 51-70 22 cases of 71-90 5 cases of 91-100 and at last CONSTANT Score- 12th month 1 cases 56-70 15 cases of 71-85 14 cases of 86-100

Conclusion: TENS is a safe, stable, minimally invasive surgical technique in indicated cases with reduced duration of the surgery, decrease the surgical site morbidity, early mobilization, faster return to daily activities, excellent cosmetic results with a lower complication rate.

Keywords: TENS, Clavicle, Union

References

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How to Cite this article: Chhawra S, Aggarwal R, Jain R, Gupta A, Nagar N, Anand R, Mudgal R, Swarnkar H | A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail | January-June 2026; 12(1): 36-43 |

https://doi.org/10.13107/ti.2026.v12.i01.86

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Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

April 10, 2026/in January-June 2026 | Volume 12 | Issue 1

DOI: https://doi.org/10.13107/ti.2026.v12.i01.84

Submitted: 04/03/2023; Reviewed: 27/03/2023; Accepted: 07/05/2023; Published: 10/04/2026

Authors: Sachin Kale [1], Nilesh Kamat [1], Shailesh Pai [1], Ashok Shyam [1], Gaurav Sharma [1], Nikhil Makhija [1], Riddhi Shah [1]

[1] Department of Orthopaedics, Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India. Address of Correspondence Dr. Sachin Kale Department of Orthopaedics, Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India. E-mail: sachinkale@gmail.com

Abstract

Background: Proximal humerus fractures accounts for 5-6% of all adult fractures, treatment of which still remains controversial. The present review highlights the clinical review and propose a decision making framework for the treatment of proximal humerus fractures.

Methods: This narrative review focuses on key principles that directly influence day-to-day clinical decision-making. The review has been subdivided into sections covering anatomy and biomechanics, Clinical evaluation and imaging, various classification systems, decision-making and complications.

Conclusion: The management of proximal humerus fractures should always be individualized, integrating fracture-specific factors such as pattern, displacement, and vascular compromise with patient-related considerations including age, bone quality, and functional expectations. A thorough understanding of anatomy, biomechanics, and available treatment modalities is essential for optimal outcomes. Advances in fixation techniques and the increasing role of shoulder arthroplasty—especially reverse shoulder arthroplasty—have significantly improved functional results, particularly in the elderly population. Careful patient selection and adherence to sound surgical principles remain the cornerstone of successful management.

Keywords: Proximal Humerus fracture, Clinical decision making, Neer classification

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How to Cite this article: Kale S, NKamat N, Pai S, Shyam A, Sharma G, Makhija N, Shah R | Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework | January-June 2026; 12(1): 31-35 |

https://doi.org/10.13107/ti.2026.v12.i01.84

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

Full Sized Blog Element (Big Preview Pic)

A Prospective Study to Assess Radiological and Functional Outcomes in the Surgical Management of Displaced Middle Third Clavicle Fractures Fixed with TENS Titanium Elastic Intra-Medullary Nail

Authors: Sanjay Chhawra [1], Rahul Aggarwal [1], Raman Jain [1], Amit Gupta [1], Amit Nagar [1], Rishav Anand [1], Rajat Mudgal [1], Hritik Swarnkar [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

Comprehensive Management of Proximal Humerus Fractures in Adults: A Practical Clinical Review and Decision-Making Framework

Authors: Sachin Kale [1], Nilesh Kamat [1], Shailesh Pai [1], Ashok Shyam [1], Gaurav Sharma [1], Nikhil Makhija [1], Riddhi Shah [1]

Abstract

References

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