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Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

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Abstract

Purpose

Locking plate osteosynthesis has become the preferred method for operative treatment of clavicle fractures. The method offers stable fixation, and would theoretically be associated with a low rate of fracture-related complications and reoperations. However, this remains to be explored in a large cohort, and our purpose was to assess the overall rates of complications and reoperations following locking plate osteosynthesis of mid-shaft clavicle fractures.

Methods

We identified all locking plate osteosynthesis of mid-shaft clavicle fractures operated upon in our department from January 2008 to November 2010 (n = 114). Nine patients did not attend the follow-up at our institution. The study group of 105 fractures (104 patients, 86 males) had a median age of 36 years (14–75 years). Follow-up ranged from 0.5 to 3.5 years. No patients were allowed to load the upper extremity for six weeks. By studying patient files and radiographic material, we assessed complications and reoperations.

Results

Overall, there were 31 cases (30 %) of plate removals for discomfort. There were five cases (5 %) of failure of osteosynthesis: two occurred early after approximately six weeks and three late after ten to 13 months postoperatively.

Conclusion

The overall rate of failure of osteosynthesis is low (5 %). The burden of plate removals in approximately one third of patients should be included in the preoperative information.

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References

  1. Postacchini F, Gumina S, De Santis P (2002) Epidemiology of clavicle fractures. J Shoulder Elbow Surg 11(5):452–456

    Article  PubMed  Google Scholar 

  2. Nordqvist A, Petersson C (1994) The incidence of fractures of the clavicle. Clin Orthop Relat Res 300:127–32

    PubMed  Google Scholar 

  3. Postacchini R, Gumina S, Farsetti P, Postacchini F (2010) Long-term results of conservative management of midshaft clavicle fracture. Int Orthop 34(5):731–736

    Article  PubMed  Google Scholar 

  4. Canadian Orthopaedic Trauma Society (2007) Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 89(1):1–10

    Google Scholar 

  5. VanBeek C, Boselli KJ, Cadet ER, Ahmad CS, Levine WN (2011) Precountered plating of clavicle fractures. Decreased hardware-related complications. Clin Orthop Relat Res 469:3337–3343

    Article  PubMed  Google Scholar 

  6. Wijdicks FJ, Van der Meijden OA, Millett PJ, Verleisdonk EJ, Houwert RM (2012) Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg 132(5):617–25, Epub 2012 Jan 10

    Article  PubMed  Google Scholar 

  7. Demirhan M, Bilsel K, Atalar AC, Bozdag E, Sunbuloglu E, Kale A (2011) A Biomechanical comparison of fixation techniques in midshaft clavicular fractures. J Orthop Trauma 25(5):272–278

    Article  PubMed  Google Scholar 

  8. Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A, Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A (2008) Biomechanical evaluation of clavicle fracture plating techniques: does a locking plate provide improved stability? J Orthop Trauma 22(4):241–247

    Article  PubMed  Google Scholar 

  9. Eden L, Doht S, Frey SP, Ziegler D, Stoyhe J, Fehske K, Blunk T, Meffert RH (2012) Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation. Int Orthop 36(12):2537–2543

    Article  PubMed  Google Scholar 

  10. Pai HT, Lee YS, Cheng CY (2009) Surgical treatment of midclavicular fractures In the elderly: a comparison of locking and nonlocking plates. Orthopedics 32(4)

  11. Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br 80(3):476–84 (Edinburgh classification)

    Article  PubMed  CAS  Google Scholar 

  12. Kabak S, Halici M, Tuncel M, Avsarogullari L, Karaoglu S (2004) Treatment of mid-clavicular nonunion: comparison of dynamic compression plating compression plating techniques. J Shoulder Elbow Surg 13:396–403

    Article  PubMed  Google Scholar 

  13. Collinge C, Devinney S, Herscovici D (2006) Anterior-inferior plate fixation of middle-third fractures and nonunions of the clavicle. J Orthop Trauma 20:680–686

    Article  PubMed  Google Scholar 

  14. Ban I, Branner U, Holck K, Krasheninnikoff M, Troelsen A (2012) Clavicle fractures may be conservatively treated with acceptable results - a systematic review. Dan Med J 59(7):A4457

    PubMed  Google Scholar 

  15. Campochiario G, Tsatsis C, Gazzotti G, Rebuzzi M, Catani F (2012) Displaced mid- shaft clavicular fractures: surgical treatment with a precountered angular stability plate. Musculoskelet Surg 96(Suppl 1):21–26

    Article  Google Scholar 

  16. Coupe BD, Wimhurst JA, Indar R (2005) A new approach for plate fixation of midshaft clavicular fractures. Injury 36:1166–1171

    Article  PubMed  CAS  Google Scholar 

  17. Bostman O, Manninen M, Pihlajamaki H (1997) Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma 43:778–783

    Article  PubMed  CAS  Google Scholar 

  18. Wang J, Chidambaram R, Mok D (2011) Is removal of clavicle plate after fracture union necessary? Int J Shoulder Surg 5(4):85–89

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinical Orthopaedic Research, Department of Orthopaedics, Hvidovre University Hospital, Copenhagen, Denmark

    Marie Fridberg, Ilija Ban, Zaid Issa, Michael Krasheninnikoff & Anders Troelsen

Authors
  1. Marie Fridberg
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  2. Ilija Ban
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  3. Zaid Issa
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  4. Michael Krasheninnikoff
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  5. Anders Troelsen
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Correspondence to Marie Fridberg.

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Fridberg, M., Ban, I., Issa, Z. et al. Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases. International Orthopaedics (SICOT) 37, 689–692 (2013). https://doi.org/10.1007/s00264-013-1793-9

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  • DOI: https://doi.org/10.1007/s00264-013-1793-9

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