Symptomatic Implant Removal Following Dual Mini-Fragment Plating for Clavicular Shaft Fractures

Czajka, Cory M.; Kay, Andrew B.; Gary, Joshua L.; Prasarn, Mark L.; Choo, Andrew M.; Munz, John W.; Harvin, William H.; Achor, Timothy S.

doi:10.1097/bot.0000000000000760

Cited by 28 publications

(41 citation statements)

References 25 publications

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“…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%

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: Introductionmentioning

confidence: 99%

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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“…Additionally, it is important to note that the primary impetus for using the dual-plating technique is not specifically to lessen implant removal. As noted by previous studies using dual plating, dual plating of the clavicle is advantageous for the reduction, maintenance of reduction, and fixation of complex fracture patterns 14 , 21 - 23 . Because of the retrospective nature of the study, the ASES Standardized Shoulder Assessment Form was unable to be administered to patients who required implant removal before their implants were removed.…”

Section: Discussionmentioning

confidence: 76%

“…Clinically, they reported 0 implant removals at 1 year of follow-up 14 . Another dual mini-fragment plating series, by Czajka et al, published in 2017, showed an all-cause reoperation rate of 7.4% 21 , which was slightly higher than that of Prasarn et al 14 , although still lower than published single-plate data.…”

Section: Discussionmentioning

confidence: 78%

Dual Versus Single-Plate Fixation of Midshaft Clavicular Fractures

et al. 2020

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“…All patients showed radiological healing of the fracture, and no further surgery was necessary [4]. In a larger series at the University of Houston, Texas with 81 patients treated with the identical technique, good functional results with a mean DASH score of 8.4 points were found at a median of 477 days postoperatively [5]. In one patient (1.2 %), there was an early loss of reduction during weight lifting 4 weeks postoperatively, necessitating revision of open reduction and internal fixation (ORIF).…”

Section: Claviclementioning

confidence: 84%

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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Symptomatic Implant Removal Following Dual Mini-Fragment Plating for Clavicular Shaft Fractures

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 28 publications

References 25 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

Dual Versus Single-Plate Fixation of Midshaft Clavicular Fractures

Clinical Application and Outcomes of Upper Extremity Double Plating

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