Is plating of mid-shaft clavicular fractures possible with a conventional straight 3.5 millimeter locking compression plate?

OBJECTIVES Current literature describes improved clinical outcomes and a minor rate of pseudoarthrosis following operatively treated clavicular fractures. We investigated the feasibility of using a standard 3.5 mm AO locking compression plate (LCP) of adequate length for the stabilisation of mid-shaft fractures of the clavicle. METHODS The length and acromial and diaphyseal curvature depths were measured in 49 cadaveric clavicles. We then assessed how well the 6, 7, 8 and 9-hole plates fit on the clavicles. RESULTS The mean clavicular length was 155±12 mm, with a mean acromial curvature of 18.1±3.7 mm and a mean diaphyseal curvature of 12 mm±4 mm. The optimum plate for the clavicle was a 7-hole LCP, providing adequate fixation in 48 of the 49 clavicles. CONCLUSION The described technique for plate osteosynthesis of the clavicle with AO locking compression plate is feasible and results in a biomechanically strong construct for mid-shaft fractures. With the use of a locking plate, comminuted fractures may be bridged without a reduction in the strength of the construct.