Does plate type influence the clinical outcomes and implant removal in midclavicular fractures fixed with 2.7-mm anteroinferior plates? A retrospective cohort study

Journal of Orthopaedic Surgery and Research

Martin F Hoffmann¹  Debra L Sietsema²  Clifford B Jones²  Alex K Gilde³ 

[1] BG-University Hospital Bergmannsheil, Bürkle de la Camp-Platz 1, Bochum 44789, Germany;Orthopaedic Associates of Michigan, 230 Michigan NE, Ste 300, Grand Rapids 49503, MI, USA;Michigan State University College of Human Medicine, 15 Michigan Street NE, Grand Rapids 49503, MI, USA

关键词: mm;    2.7 ;    Dynamic compression;    Reconstruction;    Internal fixation;    Open reduction;    Clavicle fracture;   

Others  :  1152498
DOI  :  10.1186/s13018-014-0055-x

 received in 2014-02-25, accepted in 2014-06-20,  发布年份 2014

【 摘 要 】

Background

The purpose of this study was to evaluate surgical healing rates, implant failure, implant removal, and the need for surgical revision with regards to plate type in midshaft clavicle fractures fixed with 2.7-mm anteroinferior plates utilizing modern plating techniques.

Methods

This retrospective exploratory cohort review took place at a level I teaching trauma center and a single large private practice office. A total of 155 skeletally mature individuals with 156 midshaft clavicle fractures between March 2002 and March 2012 were included in the final results. Fractures were identified by mechanism of injury and classified based on OTA/AO criteria. All fractures were fixed with 2.7-mm anteroinferior plates. Primary outcome measurements included implant failure, malunion, nonunion, and implant removal. Secondary outcome measurements included pain with the visual analog scale and range of motion. Statistically significant testing was set at 0.05, and testing was performed using chi-square, Fisher’s exact, Mann–Whitney U, and Kruskall-Wallis.

Results

Implant failure occurred more often in reconstruction plates as compared to dynamic compression plates (p = 0.029). Malunions and nonunions occurred more often in fractures fixed with reconstruction plates as compared to dynamic compression plates, but it was not statistically significant. Implant removal attributed to irritation or implant prominence was observed in 14 patients. Statistically significant levels of pain were seen in patients requiring implant removal (p = 0.001) but were not associated with the plate type.

Conclusions

Anteroinferior clavicular fracture fixation with 2.7-mm dynamic compression plates results in excellent healing rates with low removal rates in accordance with the published literature. Given higher rates of failure, 2.7-mm reconstruction plates should be discouraged in comparison to stiffer and more reliable 2.7-mm dynamic compression plates.

【 授权许可】

   
2014 Gilde et al.; licensee BioMed Central Ltd.

【 图 表 】

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