Dual mini-fragment plating for midshaft clavicle fractures: a clinical and biomechanical investigation

Prasarn, Mark L.; Meyers, Kathleen N.; Wilkin, Geoffrey; Wellman, David S.; Chan, David; Ahn, Jaimo; Lorich, Dean G.; Helfet, David L.

doi:10.1007/s00402-015-2329-0

Cited by 61 publications

(92 citation statements)

References 27 publications

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“…However, the dual plate fixation model indicated greater stability for fracture treatment. [10,11,13,14,16]. It is meaningful for surgeons to evaluate the biomechanical performance of implants for the reason of improving the treatment result of clavicle fracture.…”

Section: Micro-motionsmentioning

confidence: 99%

“…Although various fixation methods of midshaft clavicle fractures have been reported by multifarious techniques, plate fixation remains the most established method. Fixations including anterior plate, superior plate, or spiral plate, and, more recently, dual small plate fixation have been reported as can minimize hardware-related complications [2,7,[9][10][11][12]. Plate hardware irritation and prominence are commonly reported as reasons for revision surgeries [3,6,13].…”

Section: Introductionmentioning

confidence: 99%

“…On the contrary, higher patient cosmetic acceptability has been reported with small single plate fixation compared with larger, more prominent plates (95% vs 50%, respectively). Recently, excellent clinical outcomes, 100% union rate, and 0% reoperation rate have been reported with dual small plate fixation [7,10,11,[13][14][15][16]. This has caused clinical interest in dual small plating, to minimize hardware irritation and reoperation rates.…”

Section: Introductionmentioning

confidence: 99%

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Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

Zhang

Chen

et al. 2020

J Orthop Surg Res

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Background: Midshaft clavicle fractures are one of the most familiar fractures. And, dual small plate fixation has been reported as can minimize hardware-related complications. However, the biomechanical properties of the dual small plate fixation have not yet been thoroughly evaluated. Here, we report the results of a finite element analysis of the biomechanical properties of midshaft clavicle fractures treated with dual small plating and superior and anteroinferior single plate fixation. Methods: A three-dimensional (3D) finite element model of the midshaft clavicle fractures was created, whose 4mm transverse fracture gap, having an angle < 30 degree and devoid of overlapping triangles, was simulated between the fractured segments of the middle-shaft of the clavicle. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis. Results: No significant differences were found between dual plating, superior or anteroinferior single plating in cantilever bending, axial compression, and axial torsion. Dual plating with a smaller plate-screw construct is biomechanically eligible to compare with superior and anteroinferior single plate fixation using larger plate-screw constructs.Conclusions: This study demonstrated that larger plate-screw constructs for the treatment of simple are placed clavicular fractures; however, weight-bearing and exorbitant shoulder activity should be avoided after the operation. Therefore, dual plating may provide a viable option for fixing midshaft clavicle fractures and, thus, may be preferred for patients who need early activity.

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Section: Micro-motionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

Zhang

Chen

et al. 2020

J Orthop Surg Res

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“…While there is a general shift in preference towards mini-fragment fixation and these have been used clinically with successful outcomes (Jones et al, 2009), this approach in scapular neck fractures has not been evaluated against the standard fixation techniques. In contrast, several studies have investigated the biomechanical outcomes of various clavicle fixation methods (Bravman et al, 2015;Celestre et al, 2008;Prasarn et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Mechanical testing of scapular neck fracture fixation using a synthetic bone model

Sulkar

Tashjian

Chalmers

et al. 2019

Clinical Biomechanics

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“…Prasarn et al published their biomechanical and clinical results after DPO for the primary treatment of shaft fractures with superior 2.7 mm reconstruction plate and anterior 2.4 mm LCP in 2015 [3]. Biomechanically, multiplanar bending stiffness was improved compared to isolated anterior or superior 3.5 mm plating.…”

Section: Claviclementioning

confidence: 99%

Clinical Application and Outcomes of Upper Extremity Double Plating

et al. 2019

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Dual plating in fractures of the upper extremity is well established for the distal humerus. The indication for the use of dual plating has been expanded over the last few years. While dual plating was originally frequently used in revisions of non-unions, it is nowadays also used in primary fixation of diverse complex fractures of the upper extremity. The high biomechanical fixation strength of dual plating is advantageous in regions with high bending and torsional stresses, such as the humeral shaft. An additional anterior plate provides high fixation strength and reduces the risk of loss of reduction in complex proximal humeral fractures and allows for direct fixation of lesser tuberosity fragments. Low-profile plates have been introduced for complex proximal ulna fractures. In dual plating the improved mechanical stability is combined with a reduced risk of implant related soft tissue irritations. The present article provides an overview of current indications for dual plating of upper extremity fractures and outlines technical aspects as well as advantages over conventional fixation techniques.

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Dual mini-fragment plating for midshaft clavicle fractures: a clinical and biomechanical investigation

Cited by 61 publications

References 27 publications

Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

Mechanical testing of scapular neck fracture fixation using a synthetic bone model

Clinical Application and Outcomes of Upper Extremity Double Plating

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