Title: Anatomical Precontoured Locking Plate versus Reconstruction Plate in Unstable Clavicular Fractures

Authors: Prof. Dr R. Neelakrishnan, Dr D.Ganesh, Dr V.Barathiselvan, Dr P.S.Balamurugavel, Dr K.Parasuraman, Dr R.Ravikrishna

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.158

Abstract

Introduction: For the fixation of unstable clavicular fractures, unique plates are available with merits and demerits. Reconstruction plates are reasonably-priced but their strength and rigitidy had been doubtful. The anatomical pre contoured locking plates offer better stability in comparison with the reconstruction plate.

Materials and Methods: We have analyzed prospectively 40 unstable clavicular fractures treated surgically with pre contoured anatomical locking plate (20cases) or reconstruction plate (20 cases) for patients admitted in our institute between June 2018 and Oct 2019. The clinical and radiological results among the reconstruction plate and pre contoured anatomical locking plate have been compared by Quick Disability of the Arm, Shoulder and Hand (DASH) score and plain radiographs, respectively.

Results: The mean time of union was16.3 weeks with the reconstruction plate as compared with 13.4 weeks with the pre contoured locking plate. The Quick DASH score was 32.65 in the reconstruction plate patients and 25.44 in the pre contoured locking plate group. Screw cut out and plate failures were found within the reconstruction plate group which needed removal of implant. The mean follow-up month was 16.44 months (14–31 months).  Implant removal was carried out in three patients in the reconstruction group and one patient in pre contoured plate group.3 nonunion occurred with recon plate and one with pre contoured plate.

Conclusion: Surgical management of unstable clavicle fractures with anatomical pre contoured locking plate results instable fixation, early union, and better results in comparison with the reconstruction plating.

Keywords: anatomical pre contoured plate fixation, quick DASH score, reconstruction plate fixation.

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Corresponding Author

Prof. Dr R. Neelakrishnan

Professor and Head, Department of Orthopaedics, Rajah Muthiah Medical College & Hospital, Annamalai University