Double-plate fixation in lateral clavicle fractures-a new strategy

Lateral clavicle fractures Neer type II often lead to the dislocation of the medial fragment and an increased rate of nonunion after conservative treatment. Therefore, most authors recommend an open reduction and internal fixation. Double-plate fixation is a common technique in the treatment of complex radius fractures. The authors use it as a routine procedure in the treatment of lateral clavicle fractures Neer type II. In this article, we present our experiences.

From January 2006 to June 2008, 11 patients with lateral clavicle fractures of Neer type II were treated with an open reduction and internal fixation using the double-plate technique.

All patients showed osseous union on radiographs after 10 weeks to 16 weeks. In eight of nine cases, the operated shoulder regained full range of motion. In all patients, we observed immediate postoperative recovery without severe complications. One female patient complained about slight pain and restricted motion in abduction of > 90°. In two patients, we observed the migration of one screw. It was removed under local anesthesia 9 weeks and 26 weeks after surgery.

This study, for the first time, describes the technique of double-plate fixation for the treatment of lateral clavicle fractures. This technique provides a stable fixation even in small and comminuted distal fragments.