Dual plating with an anteroinferior miniplate in multifragmentary clavicular midshaft fractures

Abstract

Background We developed a novel surgical technique using an anteroinferior locking compression miniplate in addition to a conventional superior compression plate for the treatment of multifragmentary clavicular fractures. Methods We retrospectively reviewed the medical and radiologic records of patients who were surgically treated with dual plating for clavicle fractures from March 2019 to November 2020. The primary outcome was bone union, and the secondary outcome was postoperative complications associated with the procedure. The functional outcomes included the visual analog scale (VAS), University of California at Los Angeles Shoulder Scale (UCLASS) and Constant-Shoulder Scale (CSS) scores. Results Twenty patients with AO/OTA 15-2B and 2C clavicular fractures were followed for an average of 16 months (range: 8 ~ 30). The average patient age was 41 (range: 21 ~ 76) years, and 17 male and 3 female patients were included. The most common cause of clavicle fractures was sports activity (35%). The average number of fragments was 1.5 (range: 1 ~ 3). Ten patients had AO/OTA classification 15-2C, and 9 patients had AO/OTA classification 15-2B. Primary fracture union healing was observed in all 20 (100%) patients, and the average time to bone union was 11.8 weeks (range: 7 ~ 21). There was no fixation failure or postoperative infection. The mean VAS, UCLASS and CSS scores at the final follow-up were 0.45, 33.3 and 65.0, respectively. Conclusion Dual plating using an anteroinferior locking compression miniplate is an effective surgical technique for treating multifragmentary clavicular fractures.