Bryan J M van de Wall, Nadine Diwersi, Lukas Scheuble, Yannic Lecoultre, Björn Christian Link, Reto Babst, Frank J P Beeres
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引用次数: 0
Abstract
Objective: The aim of this surgical technique is fracture healing with anatomical alignment and less implant irritation due to smaller, low-profile plates. Equal to superior stability is provided compared to single superior- or anterior-based plates.
Indications: The same general indications for surgical stabilization of clavicle fractures apply for low-profile double plating and include fracture displacement of one or more shaft width, shortening of more than 1 cm in length, and patients with high physical activity levels. Double plating is especially suitable for fractures in the midportion of the clavicle.
Contraindications: Fractures in the far lateral portion of the clavicle due to physiological thinning of the clavicle potentially causing problems with screw purchase of screws fitted in the anterior plate.
Surgical technique: A 2.0 mm low-profile mini plate is used on the superior and a 2.4 or 2.7 mm on the anterior surface of the clavicle. The plates are fixated with a minimum of two cortical or locking screws on each side of the fracture in each plate. A lag screw can be used if absolute stability can be obtained in simple fractures.
Postoperative management: A standard functional postoperative regime can be followed after plate fixation with free mobilization up to 90° without weight bearing for 6 weeks. Afterwards free range of motion and weight bearing are allowed.
Results: A biomechanical study, meta-analysis, and retrospective analysis have shown that low profile double plating offers equal to superior stability, lower rates of implant irritation and subsequent removal compared to conventional single plating with equal healing potential.
期刊介绍：
Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care.
The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems.
Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
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