Comparison of Dynamic and Locked Compression Plates for Treating Midshaft Clavicle Fractures

Full article available online at Healio.com/Orthopedics. Search: 20120426-24 The purpose of this study was to compare the parameters of perioperative course and cost-effectiveness for patients with midshaft clavicle fractures treated by dynamic compression plates or locked compression plates. This retrospective, case-controlled study involved 54 patients with midshaft clavicle fractures who received dynamic compression plates (n521) or locked compression plates (n533) between January 2002 and December 2008. Indications for surgery included displacement or shortening .2 cm, comminuted fractures, and skin tenting. Patients with previous malunion, nonunion, multiple injuries of the shoulder girdle, or open fractures were excluded. Preoperative demographics showed no statistically significant differences between the 2 groups. Eighteen patients with dynamic compression plates and 28 patients with locked compression plates with postoperative follow-up .1 year were included for comparison. Statistical analyses for operative time, blood loss, complication rate, hospital stay, and union rate demonstrated no statistically significant difference between the 2 groups. The only statistically significant difference was a higher rate of plate removal requests in the dynamic compression plate group. Considering medical expenditure, locked compression plates cost 6 times more than dynamic compression plates in the authors’ institution (US $600 vs $100, respectively). Other than more plate removal requests in the dynamic compression plate group and greater expense in the locked compression plate group, dynamic compression plates and locked compression plates achieved satisfactory operative outcomes in treating midshaft clavicle fractures, with no statistically significant difference between perioperative course and eventual fracture union observed between the 2 groups. Drs Lai, Hsu, Chang, Yang, and Renn are from the Department of Orthopaedics, Dr Tarng is from the Department of Emergency Medicine, Kaohsiung Veterans General Hospital, and Dr Hsu is also from the School of Nursing, Fooyin University, Kaohsiung, Taiwan. Drs Lai, Tarng, Hsu, Chang, Yang, and Renn have no relevant financial relationships to disclose. Correspondence should be addressed to: Chien-Jen Hsu, MD, Department of Orthopaedics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, Kaohsiung 813, Taiwan (mauricecjhsu@hotmail.com). doi: 10.3928/01477447-20120426-24 Comparison of Dynamic and Locked Compression Plates for Treating Midshaft Clavicle Fractures Yu-Cheng Lai, MD; Yih-Wen Tarng, MD, PhD; Chien-Jen hsu, MD; Wei-ning Chang, MD, Ms; shan-Wei Yang, MD; Jenn-huei renn, MD, PhD Figure: Preoperative anteroposterior radiograph showing an AO/OTA 06-B1 right clavicle fracture (A). Postoperative anteroposterior radiograph after open reduction and internal fixation with a 3.5-mm locked compression plate (B). A