ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Clavicle refractures after hardware removal: are there risk factors? A retrospective cohort study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Refracture after implant removal of the clavicle: a retrospective cohort analysis.Journal of orthopaedic surgery and research · 2026Article
- Practice patterns in indications, timing, and imaging for clavicle hardware removal: a survey among German-speaking shoulder surgeons.BMC musculoskeletal disorders · 2026Article
- Hook plate versus locking plate fixation in lateral clavicle fractures: operative efficiency and cumulative surgical burden in a propensity score-matched cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Biomechanical Study of Load to Failure of a Bone Model After Removal of a 2.7-mm or 3.5-mm Plate.Cureus · 2026Article
- Immediate radiographic reduction loss but preserved clinical outcomes after hardware removal in lateral clavicle fractures treated with plate fixation and coracoclavicular augmentation.BMC musculoskeletal disorders · 2026Article
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Authors and funding
9 authors.
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Abstract
purposeRemoval of symptomatic hardware after fracture fixation is common, especially in patients with clavicle fracture. Yet, refracture after hardware removal is a relatively common complication in those patients. The aim of this study was to identify risk factors for clavicle refractures that could be influenced by the surgical treatment provided.
methodsAll patients from a level one trauma center from 2017 to 2022 were screened for eligibility. Inclusion criteria included hardware removal after plate osteosynthesis of the clavicle, age ≥ 18 years, and signed informed consent. Groups were stratified according to occurrence of refracture: no-refracture (NR) vs. refracture (R). Nearest-neighbor matching in a ratio of 5:1 was performed. Parameter investigated included baseline demographics, fracture characteristics and surgical treatment details. A subgroup analysis of only clavicle shaft fractures was performed.
resultsSixty patients were included with 50 patients in Group NR and 10 in Group R. Baseline characteristics were comparable between the groups. A subgroup analysis on shaft fractures revealed that a significantly larger working length (number of empty screw holes adjacent to the fracture site) in Group NR (1.94 ± 0.85) compared to the refracture group (1.20 ± 0.92) (p = 0.042). Logistic regression yielded an inverse correlation with the number of empty screw holes to the fracture site and the occurrence of refractures (OR 0.369, 95% CI 0.132-0.873; p = 0.035). Time in situ, lag screw application, plate positioning and the total amount of screws did not affect either of the groups.
conclusionAn increased working length in patients with clavicle shaft fractures might be a protective measure for occurrence of refractures after hardware removal.
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