LCP reconstruction plates for the surgical treatment of comminuted and displaced diaphyseal clavicle fractures

Abstract

Introduction: The implants most commonly used for the surgical treatment of acute comminuted midshaft clavicle fractures with medialization of the lateral fragment greater than 20 mm are dynamic compression plates, locking plates and more recently site-specific precontoured plates. The use of reconstruction plates is usually not recommended in the acute setting due to its deformation susceptibility at the fracture site, leading to plate breakage, malunion and the need for further surgeries.

Methods: We prospectively evaluated the short term clinical results of 45 patients treated with the LCP reconstruction plate and aggressive therapist oriented physical therapy for acute midshaft comminuted clavicular fractures. We assessed the shoulder Constant score and the patient satisfaction at weeks 4, 8 and 12. Patients were then scheduled for hardware removal 1 year after clavicular fixation.

Results: We included 45 patients with average age 29.8 years old and a follow-up of 18 months each. Constant score averaged 97.5 points by 12 weeks of short term evaluation and a 100 % satisfaction rate was described by the patients. Mayor complications such as neurovascular injuries, infections, draining haematomas were not observed. Mild complications included a malunion for one patient who ignored the weight bearing restriction before week 8 of follow-up and wound dysaesthesias that were resolved after the first year when patients were scheduled for hardware removal.

Discussion: Our data suggests that LCP reconstruction plates are a viable option for a definite group of patients with this specific type of fracture with minimal complications associated with its use. A clinical trial comparing this type of hardware with another plate should be completed under the same conditions of postoperative rehabilitation.