Intuitive and Minimally Invasive Surgical Technique for Comminuted Mid-Shaft Clavicle Fractures: Fixation with an Anterior Mini Plate and Superior Locking Compression Plate.

Background: We have applied an anterior locking compression mini plate in addition to a conventional superior locking compression plate for the treatment of wedge or multifragmentary clavicular fractures. Methods: Medical and radiologic data were retrospectively reviewed for patients who underwent surgical fixation with an anterior locking compression mini plate and conventional anatomical locking compression plate in a clavicle fracture of AO/OTA 15.2 B and 15.2 C. The primary outcome was bone union, and the secondary outcome was postoperative complications associated with the procedure. The functional outcomes included the Visual Analog Scale (VAS), University of California at Los Angeles Shoulder Scale (UCLASS), and Constant Shoulder Scale (CSS). Results: Nineteen patients with AO/OTA 15.2 B and 2 C clavicular fractures were followed for an average of 16 months (range: 12-30). The average patient age was 41 (range: 21-76) years, and 17 male and 2 female patients were included. The most common cause of clavicle fractures was sports activity (36.8%). A total of 10 patients had AO/OTA classification 15.2 C, and 9 patients had AO/OTA classification 15.2 B clavicular fractures. Primary fracture union healing was observed in all 19 (100%) patients, and the average time to bone union was 11 weeks (range: 7~21). There was no fixation failure or postoperative infection. The mean VAS, UCLASS, and CSS scores at the final follow-up were 0.6, 33.4, and 65 on a 75-point scale (87 on a 100-point scale), respectively. Conclusions: Dual plating using an anterior mini plate with a superior LCP could be considered as an option to minimize soft-tissue injury in comminuted mid-shaft clavicle fractures.