Treatment of displaced clavicular shaft fracture: a comparison between locking and nonlocking reconstruction plating

Abstract

Objective To retrospectively compare the therapeutic effects of straight locking and nonlocking reconstruction plating for displaced clavicular shaft fractures. Methods Between March 2006 and January 2010, 97 patients with single-sided, isolated, displaced clavicular shaft fractures (Edinburgh 2B)were treated with open reduction and plate fixation. Thirty-seven cases (22 males and 15 females with a mean age of 41.2 years) received straight locking reconstruction plating and 60 cases (37 males and 23 females with a mean age of 38.5 years) had nonlocking reconstruction plating. We compared the hardware failure rates and the Constant-Murley scores for the suffered shoulders between the 2 groups. Results The mean follow-up period was 10. 7 months (range, 6 to 12 months) in the locking group, and 9. 8 months (range, 6 to 12 months) in the nonlocking group. In the locking plate group, 33 fractures healed uneventfully with an average healing time of 4. 6 months (range, 3 to 6 months). In the nonlocking plate group, 58 fractures healed with an average healing time of 4. 1 months (range, 3 to 6 months) . A significantly higher plate breakage rate (10. 8% ) was observed in the locking plate group than in the nonlocking group (1.7%) (x2 = 3. 914, P =0. 048). The Constant-Murley score was 87.3 ±6. 5 (range, 82 to 95) in the locking plate group and 90.4 ±3.0 (range, 83 to 97) in the nonlocking plate group, without any significant difference between the 2 groups ( t = - 0. 730, P = 0. 467 ). Conclusion It may not be appropriate to treat a displaced clavicular shaft fracture, particularly a simple one, with a straight locking reconstruction plate. Key words: Clavicle; Fractures; Internal fixators; Case-control studies