Johannes Oppermann1,2, Linda Ettmann3, Carolin Meyer3, Christian Ries3, Gregor Stein3, Christian Karl Spies4, Lars Peter Müller3,5, Christoph Faymonville3. 1. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln (AöR), Universität zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland. johannes.oppermann@uk-koeln.de. 2. Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität zu Köln, Köln, Deutschland. johannes.oppermann@uk-koeln.de. 3. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln (AöR), Universität zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland. 4. Handchirurgie, Vulpius Klinik, Vulpiusstraße 27, 74906, Bad Rappenau, Deutschland. 5. Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität zu Köln, Köln, Deutschland.
Abstract
BACKGROUND: A common method in surgical treatment of midshaft clavicular fractures is the clavicle plating system. In addition to traditional osteosynthetic devices, anatomically preformed plate systems also exist. Advantages are described in greater accuracy of fit and less irritation of surrounding soft tissues. The purpose of this study was to compare the anatomical fit of five different precontoured clavicle plating systems. MATERIAL AND METHODS: The anatomical fit of five different types of anatomical precontoured clavicle plates, 3 times VariaxSystem® (Stryker, Kalamazoo, MI), Meves® Plate (Ulrich medical Ulm, Germany) and LCP clavicle plate (Synthes, Bettlach, Switzerland) were investigated in 20 embalmed human cadaveric clavicles. An imprint of the space between the well-positioned plate and the clavicle was obtained using a silicone mass and the silicone imprint was digitally measured. Additionally, the anatomical fit was evaluated by three investigators following a standardized protocol (+2 to -2 points at lateral, midshaft and medial clavicle portions). RESULTS: The first three ranks went to the Stryker Variax-plates. They showed the least distance (Stryker 628027: 7‑hole 1.44 mm, low curvature 0.93 mm-2.36 mm, 2. Stryker 628028: 8‑hole low curvature 1.68 mm, 1.03 mm-2.4 mm and 3. Stryker 628128: 8‑hole high curvature 1.87 mm, range 1.09 mm-3.1 mm) The evaluation of the anatomical fit by the investigators was in agreement with the measurement results. CONCLUSION: Although there was no complete congruency between the plates and the clavicle, all clavicle plates investigated in this study presented a reasonable anatomical shape. The 7‑hole VariAx Stryker plate with slight curvature showed the best anatomical fit. A low profile and optimized anatomical precontouring can minimize irritation of the surrounding soft tissues and should be considered in plate design and implant choice.
BACKGROUND: A common method in surgical treatment of midshaft clavicular fractures is the clavicle plating system. In addition to traditional osteosynthetic devices, anatomically preformed plate systems also exist. Advantages are described in greater accuracy of fit and less irritation of surrounding soft tissues. The purpose of this study was to compare the anatomical fit of five different precontoured clavicle plating systems. MATERIAL AND METHODS: The anatomical fit of five different types of anatomical precontoured clavicle plates, 3 times VariaxSystem® (Stryker, Kalamazoo, MI), Meves® Plate (Ulrich medical Ulm, Germany) and LCP clavicle plate (Synthes, Bettlach, Switzerland) were investigated in 20 embalmed human cadaveric clavicles. An imprint of the space between the well-positioned plate and the clavicle was obtained using a silicone mass and the silicone imprint was digitally measured. Additionally, the anatomical fit was evaluated by three investigators following a standardized protocol (+2 to -2 points at lateral, midshaft and medial clavicle portions). RESULTS: The first three ranks went to the Stryker Variax-plates. They showed the least distance (Stryker 628027: 7‑hole 1.44 mm, low curvature 0.93 mm-2.36 mm, 2. Stryker 628028: 8‑hole low curvature 1.68 mm, 1.03 mm-2.4 mm and 3. Stryker 628128: 8‑hole high curvature 1.87 mm, range 1.09 mm-3.1 mm) The evaluation of the anatomical fit by the investigators was in agreement with the measurement results. CONCLUSION: Although there was no complete congruency between the plates and the clavicle, all clavicle plates investigated in this study presented a reasonable anatomical shape. The 7‑hole VariAx Stryker plate with slight curvature showed the best anatomical fit. A low profile and optimized anatomical precontouring can minimize irritation of the surrounding soft tissues and should be considered in plate design and implant choice.
Authors: Johannes Oppermann; Jan Bredow; Frank Beyer; Wolfram Friedrich Neiss; Christian K Spies; Peer Eysel; Jens Dargel; Max Wacker Journal: Arch Orthop Trauma Surg Date: 2014-11-12 Impact factor: 3.067
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