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

Articles in Press

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 MD, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.22038/abjs.2025.84348.3837

Abstract

Objectives: Clavicle fractures are the most frequent trauma of the scapular girdle. Fractures could be managed surgically by two main methods, either an open reduction and internal plate fixation or an intramedullary fixation. There are two commonly used positions of plate placement in clavicle fractures: anterior and superior. This randomized, double-blind clinical trial aimed to compare the outcomes of superior and anterior plate fixation methods for treating these fractures.

Methods: This randomized double-blinded clinical trial focused on patients with clavicle fractures undergoing internal plate fixation from 2020 to 2021. Patients were divided into two groups: the anterior group, which underwent internal plate fixation using an anterior-inferior plating, and the superior group, which underwent internal plate fixation using a superior plating.

Results: 75 patients were included in this study, with an average age of 42.32 in the anterior group and 40.92 in the superior group. 63 (84%) of the patients were male, and 79 (52%) of the patients had their fracture secondary to a vehicle accident. Patients in the anterior group showed their satisfaction as 96.68 (±1.13) compared to the superior group, which scored 58.08 (±12.32) (p<0.05). 10 (20%) of the patients in the superior group reported irritation by the plate after three months, while only 4 (16%) of the anterior group showed irritation (p<0.05). Two patients in the superior group showed non-union and had to undergo surgery again. There were no cases of infection or pneumothorax due to surgery. Out of the 75 patients included in this study, 2 in the superior group and 1 in the anterior group reported a loss of function even at the three-month interval.

Conclusion: Anterior plating is usually correlated with higher rates of patient satisfaction.

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The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 14 October 2025

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History

  • Receive Date: 01 December 2024
  • Revise Date: 13 October 2025
  • Accept Date: 20 July 2025

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