Abstract
BackgroundsThe aim of our study was to investigate failure rates of reconstruction plate and non-reconstruction plate, and find the best strategy for implant selection for different fracture types for midshaft clavicular fractures.Patients and methodsTwo hundred twenty-six consecutive patients with midshaft clavicular fractures who received open reduction and plate fixation during Jan 2012 to July 2017 were reviewed. The correlations between implant failure rates and risk factors including demographic data, fracture classifications, and implant types were analyzed.ResultsAO/OTA fracture classification and plate types are the most important factors affecting implant failure for midshaft clavicular fractures. Reconstruction plate had a significantly higher failure rate (53%) than that of non-reconstruction plates (3%) in comminuted midshaft clavicular (AO/OTA 15-2C) fractures (P value < 0.01). However, the difference was not significant in AO/OTA 15-2A and 2B classifications.ConclusionPatients with comminuted midshaft clavicular (AO/OTA 15-2C) fractures treated with reconstruction plates had very high implant failure rates compared to non-reconstruction plates. We suggested that patients with comminuted midshaft clavicular (AO/OTA 15-2C) fractures treated with reconstruction plates need more protection and more frequent follow-up in the postoperative period.
Highlights
Midshaft clavicular fractures were traditionally treated non-operatively, they were associated with a lower nonunion rate compared with operative treatment [1]
Recent multicenter, randomized control studies reported that open reduction and internal fixation (ORIF) had much lower nonunion and malunion rates as well as better shoulder function compared with non-operative treatment [2,3,4]
Three hundred nineteen consecutive patients received operation for acute clavicle fracture during the period Jan 2012 to July 2017 in our hospital, of whom 263 patients had a midshaft clavicular fracture that was treated with open reduction and plating
Summary
Midshaft clavicular fractures were traditionally treated non-operatively, they were associated with a lower nonunion rate compared with operative treatment [1]. Recent multicenter, randomized control studies reported that open reduction and internal fixation (ORIF) had much lower nonunion and malunion rates as well as better shoulder function compared with non-operative treatment [2,3,4]. ORIF with plates is considered to be the gold standard treatment for midshaft clavicular fracture. Implant failure for midshaft clavicular fractures may be due to bending, breakage of plates, or screw dislodgement. There are few precise data on the implant failure rates of each plate based on different fracture classifications
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