TY - JOUR
T1 - Mechanical failure of plate breakage after open reduction and plate fixation of displaced midshaft clavicle fracture-a possible new risk factor
T2 - A case report
AU - Batash, Ron
AU - Debi, Ronen
AU - Grinberg, Dan
AU - Shema, Maayan
AU - Elbaz, Avi
AU - Benedict, Yeshaiau
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/4/28
Y1 - 2019/4/28
N2 - Background: Plate breakage is one form of construct failure after a clavicle fracture treated with an open reduction and plate fixation. A recent study evaluated construct failure after an open reduction and plate fixation and reported a construct failure rate of 6.9% of which 1.9% were related to broken plates. Plate breakage is rare, thus, there are insufficient data regarding risk factors, pathogenesis, or how to avoid it. Case presentation: This case report presents an unusual case of a 35-year-old Caucasian man, 7 weeks after open reduction and internal plate fixation of a fracture in the middle third of his clavicle, who developed breakage of the implant. Surgery was advised, the implant was retrieved, the fracture was reduced, and a new bridging locking plate was implanted. Conclusions: In the current case it seems that the use of a bridging plate, the fundamental anatomical structure of the clavicle and the forces that are applied on it, the lack of discipline in complying with the postoperative functional restrictions, and an unclear "patient expectation" process were the main reasons for the failure. These aspects should be carefully considered and addressed in clavicle fractures.
AB - Background: Plate breakage is one form of construct failure after a clavicle fracture treated with an open reduction and plate fixation. A recent study evaluated construct failure after an open reduction and plate fixation and reported a construct failure rate of 6.9% of which 1.9% were related to broken plates. Plate breakage is rare, thus, there are insufficient data regarding risk factors, pathogenesis, or how to avoid it. Case presentation: This case report presents an unusual case of a 35-year-old Caucasian man, 7 weeks after open reduction and internal plate fixation of a fracture in the middle third of his clavicle, who developed breakage of the implant. Surgery was advised, the implant was retrieved, the fracture was reduced, and a new bridging locking plate was implanted. Conclusions: In the current case it seems that the use of a bridging plate, the fundamental anatomical structure of the clavicle and the forces that are applied on it, the lack of discipline in complying with the postoperative functional restrictions, and an unclear "patient expectation" process were the main reasons for the failure. These aspects should be carefully considered and addressed in clavicle fractures.
KW - Case report
KW - Clavicle
KW - Failure
KW - Open reduction and plate fixation
KW - Plate breakage
UR - http://www.scopus.com/inward/record.url?scp=85065181032&partnerID=8YFLogxK
U2 - 10.1186/s13256-019-2046-3
DO - 10.1186/s13256-019-2046-3
M3 - Article
C2 - 31029151
AN - SCOPUS:85065181032
SN - 1752-1947
VL - 13
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
IS - 1
M1 - 127
ER -