ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
Does plate position influence the outcome in midshaft clavicular fractures? A multicenter analysis.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- A novel concept for splint fixation of midshaft clavicle fractures: a biomechanical feasibility study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Low-profile 2.7 mm VA-LCP plates vs. 3.5 mm LCP plates for midshaft clavicle osteosynthesis: a retrospective comparison.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Superior versus anteroinferior plating for displaced midshaft clavicle fractures: a systematic review and meta-analysis of union, function, and complications.Clinics in shoulder and elbow · 2026Article
- Comparison of Surgical Treatment of Clavicle Fractures Using Superior and Anterior Plates: A Clinical Trial.The archives of bone and joint surgery · 2026Article
- Does butterfly fragment management affect healing following fixation of comminuted clavicle fractures?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Article
- [Surgical access route and choice of implant in the region of the clavicle shaft].Unfallchirurgie (Heidelberg, Germany) · 2024Review
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeTo date, it remains unclear whether superior or anterior plating is the best option for treating midshaft clavicular fractures. The aim of this study was to compare both techniques with regard to the incidence of implant removal due to implant irritation, risk of complications, time to union, and function.
methodsIn this retrospective cohort study, all midshaft clavicular fractures treated operatively between 2017 and 2020 in two hospitals in Switzerland were analyzed. The participating hospitals differed with regard to their standard practice; one offered superior plating only, while the other predominantly employed an anterior plate. The primary outcome was the incidence of implant removal for irritation. Secondary outcomes were time to union, complications, re-interventions, and range of motion during the follow-up period of at least 6 months.
resultsIn total, 168 patients were included in the study of which 81 (48%) received anterior plating and 87 (52%) superior plating. The overall mean age was 45 years (SD 16). There was no significant difference between anterior and superior plating with regard to implant removal (58.5% versus 57.1%, p = 0.887), infection (5.7% versus 1.8%, p = 0.071), and time to union (median 48 weeks versus 52 weeks, p = 0.643). Data on range of motion were available in 71 patients. There was no significant difference in anteflexion (median 180 degrees anterior versus 180 degrees superior) and abduction (median 180 degrees anterior versus 180 degrees superior) between the two groups.
conclusionThis retrospective cohort study did not find sufficient evidence to recommend one implant position over the other for midshaft clavicular fractures with regard to removal due to irritation. Time to union was similar and Infections were equally rare in both groups. Notably, a considerable number of patients in both groups had their implants removed due to irritation. Larger prospective studies are needed to determine how much plate position contributes to the occurrence of irritation and whether other patient or implant-related factors might play a role. Until this is clarified, implant position should be based on surgeons preference and experience.
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