Comparison of Surgical Treatment of Clavicle Fractures Using Superior and Anterior Plates: A Clinical Trial

Objectives: Clavicle fractures are the most common injuries of the scapular girdle. These fractures can be treated surgically using two primary methods: open reduction with internal plate fixation or intramedullary fixation. Plate fixation can be performed in two commonly used positions: anterior and superior. This randomized, double-blind clinical trial aimed to compare the outcomes of superior versus anterior plate fixation in the treatment of clavicle fractures. Methods: This randomized, double-blind clinical trial focused on patients with clavicle fractures who underwent internal plate fixation between ۲۰۲۰ and ۲۰۲۱. The patients were divided into two groups: the anterior group, which received internal plate fixation using an anterior-inferior plating technique, and the superior group, which received internal plate fixation using a superior plating technique. Results: A total of ۷۵ patients were included in this study, with an average age of ۴۲.۳۲ years in the anterior group and ۴۰.۹۲ years in the superior group. Sixty-three (۸۴%) of the patients were male, and ۳۹ (۵۲%) of the patients sustained their fractures as a result of vehicle accidents. Patients in the anterior group reported a satisfaction score of ۹۶.۶۸ (±۱.۱۳), compared to ۵۸.۰۸ (±۱۲.۳۲) in the superior group (p<۰.۰۵). Ten (۲۰%) patients in the superior group reported plate-related irritation after three months, while only four (۱۶%) patients in the anterior group experienced irritation (p<۰.۰۵). Two patients in the superior group developed non-union and required re-surgery. No cases of infection or pneumothorax occurred due to the surgery. Out of the ۷۵ patients included in the study, two in the superior group and one in the anterior group reported a loss of function at the three-month follow-up. Conclusion: Anterior plating is usually correlated with higher rates of patient satisfaction.         Level of evidence: I

کلیدواژه ها:

Bone Plates ، Clavicle Fractures ، Fracture fixation ، Orthopedic procedures ، Postoperative complications ، Quality of life ، surgical technique