title: Surgical treatment of displaced midshaft clavicular fractures with precontoured plates.
abstract: BACKGROUND
  Plate fixation of displaced midshaft clavicular fractures has been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with nonoperative treatment. However hardware-related complications are a problem. The new features of the precontoured locking plates may reduce the need for hardware removal, thus maintaining the advantages of plate fixation. This study evaluated the clinical outcomes of patients with displaced midshaft clavicular fractures treated with precontoured locking plates.
  
  
  METHODS
  From November 2008 to December 2012, we surgically treated 72 patients with displaced midshaft clavicular fractures. We retrospectively evaluated 68 patients who underwent 68 interventions. Postoperative functional outcomes were assessed with the Constant score, the 11-item version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire, and radiographs. Pain was subjectively assessed with a visual analog scale. Complications were recorded. Patients were asked if they were able to return to their previous employment level.
  
  
  RESULTS
  The mean follow-up period was 23.6 ± 10.7 months. The average values of the Constant, QuickDASH, and visual analog scale scores were 97.8, 1.8, and 0.4 points, respectively. At the last follow-up, 98.5% were able to return to their regular work. Of 15 complications (22.1%) that occurred, only 3 were considered as major: 1 subclavian vein extrinsic compression, 1 nonunion, and 1 hardware loosening. Hardware removal was required in 9 patients (13.2%).
  
  
  CONCLUSIONS
  Satisfactory clinical results with a low rate of complications were achieved with precontoured locking plates for displaced midshaft clavicular fractures and a low rate of hardware removal compared with traditional plates.
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors: Maximiliano
authors: M
authors: Ranalletta
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. Electronic address: luciano.rossi@hospitalitaliano.org.ar.
authors: Luciano A
authors: LA
authors: Rossi
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors: Santiago L
authors: SL
authors: Bongiovanni
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors: Ignacio
authors: I
authors: Tanoira
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors: Nicolas S
authors: NS
authors: Piuzzi
authors: Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors: Gaston
authors: G
authors: Maignon
mesh_terms: D000328:Adult; D001860:Bone Plates; D002968:Clavicle / Q000293:injuries / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D064232:Visual Analog Scale
keywords: Clavicular fracture; midshaft; plates; precontoured