Table of Contents
Advances in Orthopedic Surgery
Volume 2014 (2014), Article ID 518310, 7 pages
http://dx.doi.org/10.1155/2014/518310
Clinical Study

Analysis of Contoured Anatomic Plate Fixation versus Intramedullary Rod Fixation for Acute Midshaft Clavicle Fractures

1Los Angeles County + University of Southern California Medical Center, 1200 N. State Street, GNH 3900, Los Angeles, CA 90033, USA
2Department of Orthopedics, Los Angeles County + University of Southern California Medical Center, 1200 N. State Street, GNH 3900, Los Angeles, CA 90033, USA
3Keck School of Medicine, Kerlan-Jobe at White Memorial Medical Center, 1700 Cesar E. Chavez Avenue, Suite 1400, Los Angeles, CA 90033, USA

Received 9 September 2013; Accepted 27 January 2014; Published 2 March 2014

Academic Editor: Ely Steinberg

Copyright © 2014 Juliann Kwak-Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The recent trend has been toward surgical fixation of displaced clavicle fractures. Several fixation techniques have been reported yet it is unclear which is preferable. We retrospectively reviewed one hundred one consecutive patients with acute midshaft clavicle fractures treated operatively at a level-1 trauma center. Thirty-four patients underwent intramedullary pin fixation and 67 had anatomic plate fixation. The outcomes we assessed were operative time, complications, infection, implant failure, fracture union, range of motion, and reoperation rate. There were 92 males and 9 females with an average age of 30 years (range: 14–68 years). All patients were followed to healing with an average followup of 20 months (range: 15–32 months). While fracture union by six months and range of motion at three months were similar, the overall healing time for pin fixation was shorter . The pin group had more infections and implant failures than the plate group. Intramedullary pin fixation may have improved early results, but there was no long term difference in overall rate of union and achievement of full shoulder motion. The higher rate of implant failure with pin fixation may indicate that not all fracture patterns are amenable to fixation using this device.