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William B. Geissler, MD, Jackson , MS
Plate fixation of acute clavicle fractures is controversial. A review of the older literature suggested a potential increased nonunion complication rate with plate fixation of clavicle fractures. However, more recent literature has shown a high success in patient satisfaction rate with fixation.
The purpose of this study was to review our results with plate fixation of acute clavicle fractures. Thirty patients with acute, displaced, comminuted fractures of the middle third of the clavicle underwent plate fixation. A new, low profile, congruent plate, pre-contoured with the natural curvature of the clavicle was utilized. A special retractor was designed to protect the neurovascular structures during drilling and application of the screws. The incision is placed distal to the clavicle in the fold of the skin which allows a very cosmetic appearance.
Indications for surgery were comminuted fractures with displacement of 2 cm or more. There were twenty-one males and nine females. The average age was twenty-eight years. All patients healed their fractures and there were no complications. Patients experienced an immediate decrease in pain following fixation and early return to activities of daily living.
Recent literature of non-operative management of clavicle fractures showed a relatively high dissatisfactory rate in patients whose fractures healed with significant displacement of 2 cm or more. One recent study showed one-third of patients were dissatisfied with their deformity and function following close treatment.
Plate fixation allows for anatomic restoration of the fracture, early return to activities, high patient satisfaction.
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