Abstract: Background & Objectives:
Roughly a quarter of all clavicle fractures occur at the lateral end. Displaced fractures of the lateral end clavicle have a higher rate of nonunion. The management of fractures of the lateral end clavicle remains controversial. Open reduction internal fixation with a superiorly placed locking plate is a recently developed technique. However, there are no randomized controlled trials to evaluate the efficacy of this procedure. We present a series of nineteen cases which highlight this method of fixation for lateral end clavicle fractures. The objectives were to assess fracture stability, ac joint subluxation and functional outcome. The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw-bone interfaces rather than a single screw’s axial stiffness and pull out resistance in unlocked plates. Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilisation, avoidance of stress shielding and induction of callus formation. Further, when it is applied via a minimally invasive technique, it allows for prompt healing, lower rates of infection and reduced bone resorption as blood supply is preserved.
Methods: This study is a prospective, time bound, hospital based study conducted in Kempegowda Institute of Medical Sciences And Research Center, Bangalore, between May 2013 to May 2015. The study included 19 cases of lateral end clavicle fractures that were operated with the Locking compression plate. The fractures were classified according to Neer’s classification and were followed up at regular intervals. Clinical and radiological parameters were noted. Final functional outcome was assessed using Karlsson’s criteria for assessment of postoperative shoulder functional recovery.
Results: Good reduction was achieved in 90% of cases .17 (89%) male and 2 (11%) female patients. Average age of the patients were between 20-45 years. Type of injury was road traffic accidents 10 (54%) cases and self-fall 9(46%) cases. All fractures were simple in nature.13 cases were Neer’s type IIA & 6 cases were Neer’s type IIB.
Conclusion: Locking compression plate is a good fixation system for lateral end clavicle fractures. Operative time is reduced and surgical dissection is minimum. Device provides good angular stability and helps in early mobilization.