Superior versus anteroinferior plating of the clavicle revisited: a mechanical study. Academic Article Article uri icon

Overview

MeSH

  • Biomechanical Phenomena
  • Bone Screws
  • Fracture Fixation, Internal
  • Humans
  • Models, Anatomic

MeSH Major

  • Bone Plates
  • Clavicle
  • Internal Fixators
  • Shoulder Fractures

abstract

  • This study was designed to compare bone-implant stiffness of two fixation techniques on a sawbone model of a clavicle fracture. Twenty-four preosteotomized synthetic left clavicles (Sawbones Worldwide, Vashon, WA) were divided into four groups based on type of fixation: standard 3.5-mm pelvic reconstruction plate in the superior position; standard 3.5-mm pelvic reconstruction plate in an anteroinferior position; 3.5-mm locking pelvic reconstruction plate in a superior position; and a 3.5-mm locking pelvic reconstruction plate in an anteroinferior position. Three nondestructive cyclic mechanical tests were performed in random order: axial, torsion, and four-point bend. No significant difference was found in axial (P = 0.61) or torsional stiffness (internal rotation, P = 0.46 or external rotation, P = 0.49) among all groups. No significant difference occurred in bending rigidity (four-point bending test) with type of plate (P = 0.41), but when the plate was placed anteroinferiorly, bending rigidity was significantly higher (P < 0.001) than in the superior position. Placing the plate anteroinferiorly on the clavicle provides a more stable construct in terms of bending rigidity with no detriment in axial and torsional stiffness compared with placing the plate superiorly. We believe that anteroinferior plating is preferred as a result of the increase in bending rigidity together with other advantages, including avoidance of neurovascular compromise, the use of longer screws, and decreased hardware prominence.

publication date

  • July 2010

has subject area

  • Biomechanical Phenomena
  • Bone Plates
  • Bone Screws
  • Clavicle
  • Fracture Fixation, Internal
  • Humans
  • Internal Fixators
  • Models, Anatomic
  • Shoulder Fractures

Research

keywords

  • Comparative Study
  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1097/BOT.0b013e3181c3f6d4

PubMed ID

  • 20577072

Additional Document Info

start page

  • 420

end page

  • 425

volume

  • 24

number

  • 7