Using a reconstruction locking compression plate as external fixator in infected open clavicle fracture

Abstract

Open clavicle fracture is an uncommon injury mostly caused by severe direct trauma. It is often associated with multiple organ injuries. Generally, surgical intervention with debridement and fracture repair is always indicated in order to prevent infection, non-union, and malalignment. In situations of bony exposure and significant contamination concomitant with severe soft tissue damage, the external fixation is the treatment of choice because of the possibility it offers of providing stable fixation with minimal local tissue damage resulting in excellent union rates and better soft tissue outcome. Nevertheless, traditional external fixation encountered some potential problems as its bulkiness and sharp edges caused discomfort to the patient. In this study, we present an interesting case of a polytraumatized patient with a gunshot injury with complex open clavicle fracture that was successfully treated with external fixation using reconstruction with a locking compression plate as definitive treatment.

Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study

“…External fixators used in present clinical practice have various limitations, including insufficient fixation stiffness and strength, leading to poor healing, or high construct profiles, resulting in nonpatient friendly physical burden [13][14][15][16][17]. It is therefore essential to design a novel prototype of an external fixator for tibial fracture to increase rigidity and strength while reducing the profile of the fixation constructs.…”

Locking plate external fixation and negative pressure wound therapy for treatment of a primary infection in a closed clavicle fracture

“…The use of external fixation for the treatment of clavicle fractures has previously been described 2–5 8 9. Schuind et al 3 described a case series of clavicle external fixators, employed for a variety of different indications.…”

“…The technique has been referred to as ‘supercutaneous plating’. It has been suggested that this method may offer a number of advantages over conventional external fixation methods 8 9. The locking screw head mechanism provides an additional degree of stability to the construct, particular in its resistance of angular forces.…”

“…This was subsequently removed at 2 months and an open reduction and internal fixation was performed resulting in successful fracture healing. Another case report by Sirisreetreerux et al 9 describes the use of a 9-hole 3.5 mm LCP reconstruction plate used as an external fixation device to treat an open clavicle fracture resulting from a gunshot wound. The plate was removed after 8 weeks in situ and resulted in successful fracture union.…”

Investigating the biomechanics function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study

“…External fixators used in present clinical practice are linked to various limitations, including insufficient fixation stiffness and strength, leading to poor healing, or high profile of the constructs, resulting in non-patient friendly physical burden [13][14][15][16][17]. It is therefore essential to design a novel prototype of an external fixator for tibial fracture to increase the rigidity and strength, while reducing the profile of the fixation constructs.…”