Comparing the locking screw direction of three locking plates for lateral clavicle fractures: a simulation study

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Device Analysis

Background:

• Locking plates are effective for lateral clavicle fractures but have limitations regarding fragment size.
• Understanding screw angles and fixation capacity is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To measure screw angles of three distinct locking plates for lateral clavicle fractures.
• To assess the number of screws insertable into various fragment sizes for fixation limits.
• To determine the optimal locking plate fixation for different lateral clavicle fracture fragment sizes.

Main Methods:

• Analysis of three locking plates: Acumed distal clavicle plate, Depuy Synthes distal clavicle plate, and HOMS Engineering HAI clavicle plate.
• Measurement of screw angles in coronal and sagittal planes using computer simulation on 3D clavicle models.
• Simulation of lateral fragment sizes (10-30mm) to assess screw insertion and coverage area.

Main Results:

• The Acumed distal clavicle plate exhibited larger screw angles (20° coronal, 32° sagittal).
• The Depuy Synthes LCP clavicle plate showed a significant sagittal angle (38°).
• All plates allowed screw insertion in 25mm fragments, with the Acumed plate providing the largest coverage area.

Conclusions:

• Significant variations exist in screw angles and screw insertion capacity among different locking plates.
• For lateral clavicle fractures with fragment sizes less than 25mm, augmented fixation procedures may be required.
• The choice of locking plate should consider fragment size to ensure sufficient screw fixation.