gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2022)

25. - 28.10.2022, Berlin

Low-profile dual mini-fragment plating of diaphyseal clavicle fractures. A biomechanical comparative analysis

Meeting Abstract

  • presenting/speaker Torsten Pastor - AO Research Institute Davos, Lucerne Cantonal Hospital, Lucerne, Switzerland
  • Matthias Knobe - Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Luzern, Switzerland
  • Bryan Van de Wall - Luzerner Kantonsspital, Luzern, Switzerland
  • Ivan Zderic - AO Research Institute Davos, Davos Platz, Switzerland
  • Ingmar Rompen - Luzerner Kantonsspital, Luzern, Switzerland
  • Björn-Christian Link - Luzerner Kantonsspital, Luzern, Switzerland
  • Reto Babst - Luzerner Kantonsspital, Luzern, Switzerland
  • Boyko Gueorguiev-Rüegg - AO Research Institute Davos, Davos Platz, Switzerland
  • Frank Beeres - Luzerner Kantonsspital, Luzern, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022). Berlin, 25.-28.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAB76-610

doi: 10.3205/22dkou606, urn:nbn:de:0183-22dkou6067

Published: October 25, 2022

© 2022 Pastor et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Implant removal rates after clavicle plating are high. Recently, low-profile dual mini-fragment plate constructs have proven safe for the fixation of diaphyseal clavicle fractures.

Aims of the study were (1) to investigate the biomechanical competence of different dual plate designs in terms of stiffness and cycles to failure, and (2) to compare them against 3.5mm single superoanterior plating.

Methods: 12 artificial clavicles were assigned to 2 groups and instrumented with titanium matrix mandible plates as follows: group1 (2.5mm anterior+2.0mm superior) and group2 (2.0mm anterior+2.0mm superior). An unstable clavicle shaft fracture (AO/OTA15.2C) was simulated. Specimens were cyclically tested to failure under craniocaudal cantilever bending, superimposed with torsion around the shaft axis and compared to previous published data of 6 locked superoanterior plates tested under the same conditions (group3).

Results and conclusion: Displacement (mm) after 5000 cycles was highest in group3 (10.7±0.8) followed by group2 (8.5±1.0) and group1 (7.5±1.0), respectively. Both outcomes were significantly higher in group3 as compared to both groups1 and 2 (p<0.027). Cycles to failure were highest in group3 (19536±3586) followed by group1 (15834±3492) and group2 (11104±3177), being significantly higher in group3 as compared to group2 (p=0.004).

Low-profile 2.0/2.0 dual plates demonstrated similar initial stiffness compared to 3.5mm single plates, however, they revealed significantly lower endurance to failure. Moreover, low-profile 2.5/2.0 dual plates showed significant higher initial stiffness and similar resistance to failure compared to 3.5mm single locked plates and can therefore be considered as a useful alternative for diaphyseal clavicle fracture fixation. These results complement the promising results of several clinical studies.