Superior clavicle plate with lateral extension for displaced lateral clavicle fractures: a prospective study

Abstract

BackgroundUntil now there have been no prospective studies describing the results of using the superior clavicle plate with lateral extension in patients with displaced lateral clavicle fractures (Neer type 2). The purpose of this study was to evaluate the results of applying this plate for this specific type of fracture.Materials and methodsIn this prospective study, seven patients (mean age 43, M:F; 6:1) with a fresh displaced lateral clavicle fracture were evaluated with a mean follow-up of 10 months. Analysis included functional and subjective outcome, time until union, time until return to work, and complications.ResultsAll patients achieved clinical and radiological union within 6–12 weeks. Full range of motion as well as a return to work was achieved in most cases within 2 weeks. The mean Constant score was 98 (range 90–100), the DASH score was 3.6 (range 0–11.4), and the Shoulder Rating Questionnaire score was 97 (range 96–100). No major complications were encountered. Three patients required plate removal: two because of a prominent and subcutaneous plate and one because of an intra-articular screw.ConclusionsIn this study, use of the superior clavicle plate with lateral extension yielded excellent results in the treatment of this difficult fracture. In particular, patients acquired full range of motion within 2 weeks, reflecting the stability of the osteosynthesis achieved with this implant.

Clinical and radiological outcome following treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension: a prospective study

“…In the presented study good to excellent functional results at a mean follow-up of one year after surgery were found. The presented results are comparable to other authors who used a locking compression plate for treating fractures of the lateral clavicle [ 5 , 6 , 17 ]. Advantages of angular stable plate systems in comparison to previous conventional osteosynthetic procedures (such as maintaining sufficient blood perfusion of the periosteum reducing the risk of bony non-union [ 23 ]) is one of the reasons for reduced complication rates.…”

“…Advantages of angular stable plate systems in comparison to previous conventional osteosynthetic procedures (such as maintaining sufficient blood perfusion of the periosteum reducing the risk of bony non-union [ 23 ]) is one of the reasons for reduced complication rates. The presented results also seem to confirm the promising clinical and radiological outcome of previous smaller case series using the same implant (Synthes® LCP superior anterior clavicle plate) [ 5 , 6 ].…”

“…This is due to high non-union rates in conservative and high complication rates in surgical treatment using conventional implants such as the hook plate or k-wire fixation [ 3 ]. However, recently developed locking compression plates (LCP) showed promising functional results in small case series [ 5 , 6 , 17 ]. In this prospective clinical trial the results of treating dislocated fractures of the lateral clavicle in 20 patients are reported using a new angular stable implant, the Synthes® LCP superior anterior clavicle plate.…”

“…The presented study collective consists of 20 consecutive patients with a mean age of 40.7 ± 11.3 years and a male–female ratio of 14:6 comparable to other outcome studies concerning age and gender [ 6 , 18 ]. Interpretation of previous case series describing follow-up of locking compression plates for treating lateral clavicle fractures is mostly limited due to small patient collectives (7–14 patients) [ 5 , 6 , 19 ]. Hence, the strength of the obtained results of follow-up examinations in low-incident diseases, such as lateral clavicle fractures, can only provide the fundament and a good starting point for further analysis.…”

“…Therefore treatment of lateral clavicle fractures was controversially discussed for a long time. Recently several authors reported promising clinical and radiological results using a new, precontoured, locking compression plate with lateral extension, the so-called LCP superior anterior clavicle plate (Depuy-Synthes®, 4528 Zuchwil, Switzerland), usable for both internal fixation of lateral clavicle fractures [ 5 , 6 ] and operative management of clavicular non-union [ 7 ]. However, up to now, there are no studies focusing on long term follow-up.…”