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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 11, 1495-1498.
doi: 10.1302/0301-620X.90B11.21096  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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A three-dimensional reconstruction plate for displaced midshaft fractures of the clavicle

J.-W. Shen, MD, Orthopaedic Surgeon1; P.-J. Tong, MD, PhD, Orthopaedic Surgeon, Professor1; and H.-B. Qu, MD, Orthopaedic Surgeon1

1 Department of Orthopaedic and Traumatic Surgery Zhejiang Province TCM Hospital, No. 54, Youdian Road, Hangzhou 310006, Zheijiang Province, People’s Republic of China.

Correspondence should be sent to Dr J.-W. Shen; e-mail: shenjw100{at}163.com

This randomised study compared outcomes in patients with displaced fractures of the clavicle treated by open reduction and fixation by a reconstruction plate which was placed either superiorly or three-dimensionally. Between 2003 and 2006, 133 consecutive patients with a mean age of 44.2 years (18 to 60) with displaced midshaft fractures of the clavicle were allocated randomly to a three-dimensional (3D) (67 patients) or superior group (66). Outcome measures included the peri-operative outcome index, delayed union, revision surgery and symptoms beyond 16 weeks. CT was used to reconstruct an image of each affected clavicle and Photoshop 7.0 software employed to calculate the percentage of the clavicular cortical area in the sagittal plane. The patients were reviewed clinically and radiographically at four and 12 months after the operation. The superior plate group had a higher rate of delayed union and had more symptomatic patients than the 3D group (p < 0.05). The percentage comparisons of cortical bone area showed that cortical bone in the superior distal segment is thicker than in the inferior segment, it is also thicker in the anterior mid-section than in the posterior (p < 0.05).

If fixation of midshaft fractures of the clavicle with a plate is indicated, a 3D reconstruction plate is better than one placed superiorly, because it is consistent with the stress distribution and shape of the clavicle.




eLetters:

Read all eLetters

A three-dimensional reconstruction plate for displaced midshaft fractures of the clavicle
Amit Kumar, et al.
J Bone Joint Surg Br Online, 21 Nov 2008 [Full text]
Authors' reply:
Jin-Wen Shen, et al.
J Bone Joint Surg Br Online, 18 Dec 2008 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General