Abstract
Purpose
Open reduction and plate fixation of displaced mid-shaft clavicle fractures has gained significant popularity following a recent multi-center randomized control trial. The purpose of this study is to describe the incidence of reoperation following plate fixation of displaced mid-shaft clavicle fractures. The secondary objective is to determine if plate design influences the incidence of reoperation.
Method
A retrospective search of our hospital database was performed to identify subjects treated with plate fixation for a displaced clavicle fracture between 2001 and 2009. Radiographs and medical records were used to identify demographic data, fracture classification, plate design, and reoperation events. Only mid-shaft (AO/OTA 15-B) fractures treated with either a Low-Contact Dynamic Compression (LCDC) plate or Pre-contoured Locking (PCL) plate were included.
Results
144 subjects were included in the study. The mean age was 36 years (95% CI 33 38 years) and the mean duration of follow-up was 60 weeks (95% CI 46 74 weeks). 60% of included fractures were wedge pattern (15-B2), followed by 35% simple (15-B1) fractures, and 5% complex (15-B3) fracture patterns. Pre-contoured locking plates were used in 92 cases (64%) and LCDC plates were used in the remaining 52 subjects (36%). 21 subjects (15%) underwent reoperation: 17% of subjects treated with LCDC plates and 13% of subjects treated with PCL plates (p=0.62). Indications for reoperation included painful hardware (86%), hardware failure (9%), and refracture (5%). There was no association between reoperation and age (p = 0.23), gender (p = 0.56), fracture type (p = 0.53), or plate design (p = 0.49).
Conclusion
This study represents a large series of displaced clavicle fractures treated with open reduction and plate fixation. Reoperation following plate fixation is relatively common and is primarily due to painful hardware. No difference in reoperation rates between LCDC and pre-contoured plates could be detected in the current sample size.
