Background: The purpose of this study was to evaluate surgical healing rates, implant failure, implant removal, and\nthe need for surgical revision with regards to plate type in midshaft clavicle fractures fixed with 2.7-mm\nanteroinferior plates utilizing modern plating techniques.\nMethods: This retrospective exploratory cohort review took place at a level I teaching trauma center and a single\nlarge private practice office. A total of 155 skeletally mature individuals with 156 midshaft clavicle fractures between\nMarch 2002 and March 2012 were included in the final results. Fractures were identified by mechanism of injury\nand classified based on OTA/AO criteria. All fractures were fixed with 2.7-mm anteroinferior plates. Primary outcome\nmeasurements included implant failure, malunion, nonunion, and implant removal. Secondary outcome\nmeasurements included pain with the visual analog scale and range of motion. Statistically significant testing was\nset at 0.05, and testing was performed using chi-square, Fisherââ?¬â?¢s exact, Mannââ?¬â??Whitney U, and Kruskall-Wallis.\nResults: Implant failure occurred more often in reconstruction plates as compared to dynamic compression plates\n(p = 0.029). Malunions and nonunions occurred more often in fractures fixed with reconstruction plates as\ncompared to dynamic compression plates, but it was not statistically significant. Implant removal attributed to\nirritation or implant prominence was observed in 14 patients. Statistically significant levels of pain were seen in\npatients requiring implant removal (p = 0.001) but were not associated with the plate type.\nConclusions: Anteroinferior clavicular fracture fixation with 2.7-mm dynamic compression plates results in excellent\nhealing rates with low removal rates in accordance with the published literature. Given higher rates of failure,\n2.7-mm reconstruction plates should be discouraged in comparison to stiffer and more reliable 2.7-mm dynamic\ncompression plates.
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