Operative treatment of clavicle midshaft fractures: comparison between reconstruction plate and reconstruction locking compression plate

Abstract

Background: To compare the outcomes of reconstruction plate and reconstruction locking compression plate (LCP) for the treatment of clavicle midshaft fractures.

Methods: Forty one patients with a clavicle midshaft fracture were treated by internal fixation with a reconstruction plate (19 patients) or reconstruction LCP (22 patients). The clinical and radiological results were evaluated according to the Quick Disability of the Arm, Shoulder, and Hand (DASH) score and plain radiographs.

Results: The mean time to union was 14.6 weeks in the reconstruction plate group compared to 13.2 weeks in the reconstruction LCP group (p > 0.05). The mean score to Quick DASH was 33.85 points in the reconstruction plate group compared to 34.81 points in the reconstruction LCP group (p > 0.05). The complications in the reconstruction plate were hypertrophic scarring in 2 cases, painful shoulder in 2 cases, limitation of shoulder motion in 2 cases, and screw loosening in 3 cases. In addition, the complications in the reconstruction LCP group was hypertrophic scarring in 4 cases, painful shoulder in 1 case and a limitation of shoulder motion in 1 case (p > 0.05).

Conclusions: This study showed radiologically and clinically satisfactory results in both groups. Overall, operative treatment with a Reconstruction plate or reconstruction LCP for clavicle shaft fractures can be used to obtain stable fixation.

Keywords: Clavicle; Fracture; Midshaft; Reconstruction locking compression plate; Reconstruction plate.

Fig. 1

Seventy years old man with a displaced midshaft clavicle fracture was treated with open reduction and internal fixation with reconstruction plate. (A) Preoperative radiograph shows a displaced fracture with comminution. (B) Immediate postoperative radiograph shows successful reduction and plate fixation with wiring. (C) Radiograph at 7 months postoperatively shows bony union despite screw loosening, but the patient did not complain pain or motion limitation.

Fig. 2

Forty-four years old man with a displaced midshaft clavicle fracture was treated by open reduction and internal fixation using a reconstruction locking compression plate. (A) Preoperative radiograph shows a displaced fracture with severe comminution. (B) Immediate postoperative radiographs show satisfactory reduction and fixation. (C) Radiograph at 8 months postoperatively shows bone union.