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KMID : 1237720230560040456
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Anatomy & Cell Biology
2023 Volume.56 No. 4 p.456 ~ p.462
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The use of precontoured plates for midshaft clavicle fractures is not always the best course of treatment
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Manmohan Patel
Mohtashim Ahmad
Natwar Agrawal
Sumit Tulshidas Patil
John Ashutosh Santoshi
Bertha Rathinam
Kusum Rajendra Gandhi
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Abstract
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Plate fixation has become the preferred approach for treating displaced midshaft clavicle fractures. However,plate fixation of the clavicle presents several unique challenges, including its complex bony architecture and its immediatesubcutaneous location. In many cases, we have observed that precontoured implants do not conform to the clavicularanatomy, and many patients complain of postoperative implant-related discomfort. A total of 111 clavicles, both left andright sides, were examined to match two commonly used designs of anatomical pre-contoured superior anterior clavicleplates, with and without lateral extension. The anteroposterior (AP) plane congruence of the plate to the underlying bone, thevertical gap between the bone and plate, and the length of the plate that was off the bone either anteriorly and/or posteriorlyat both ends of the clavicle were measured. The scoring system was used to determine the fit of the implant on the clavicle asanatomic, good, or poor. We found that the maximum superior bow of the clavicle was lateral to the midline by 30.75 mmand 30.5 mm on the right and left sides, respectively. The magnitude of the bow was 4.28 mm and 4.46 mm on the right andleft sides, respectively. We also found that the plate was a poor fit in 75.86% of cases on the left side and 73.5% of cases on theright side. Manipulating the plates during surgery was very difficult in the AP plane.
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KEYWORD
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Clavicle, Bone plate, Fracture malunion, Fracture fixation, Orthopedic procedures
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