Comparison of reconstruction plate versus locking compression plate in short-term therapeutic effects for comminuted fracture of midshaft clavicle in the aged / 中华创伤骨科杂志

ABSTRACT

Objective To compare the short-term therapeutic effects of reconstruction plate versus locking compression plate in the treatment of comminuted fracture of midshaft clavicle in the aged patients.Methods A retrospective analysis was performed of the 64 aged patients who had been treated from March 2009 to April 2015 for comminuted fracture of midshaft clavicle with reconstruction plate or locking compression plate.They were divided into 2 groups according to their treatment methods.There were 30 patients in the reconstruction plate group,14 males and 16 females with an average age of 67.9±5.6 years;there were 34 patients in the locking compression plate group,15 males and 19 females with an average age of 67.1 ± 5.3 years.The 2 groups were compared in terms of operation time,blood loss,fracture healing time,internal fixation failure and shoulder functional recovery.Results The reconstruction plate and locking compression plate groups were followed up for 13.2 ± 3.2 and 12.4 ± 2.9 months,respectively.For the 2 groups,respectively,the average operation time was 62.2 ± 10.7 min and 58.1 ± 11.4 min,the average amount of blood loss during operation 35.2 ± 10.7 mL and 30.4 ±9.6 mL,the average fracture healing time 4.7 ±0.7 months and 4.5 ± 0.7 months,and the excellent to good rate of shoulder function 86.7％ (26/30) and 91.2％ (31/34),showing no significant difference between the 2 groups (all P ＞ 0.05).Five cases (16.7％) reported plate breakage,screw loosening or delayed union due to fixation failure in the reconstruction plate group but none reported fixation failure in the locking compression plate group,showing a significant difference (P ＜ 0.05).There were no significant difference between the 2 groups in fracture nonunion,malunion,neurovascular injury or acromioclavicular arthritis (P ＞ 0.05).Conclusion Since locking compression plate may lead to a lower incidence of fixation failure compared with reconstruction plate,it is recommendable for elderly patients with comminuted fracture of midshafi clavicle.