The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

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

Document Type : RESEARCH PAPER

Authors
Mehdi Motififard 1
Mojtaba Baniasadi 1
Alireza Assadi 2
Himan Hoseini 2
Mahdi Hadian 1
1 Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22038/abjs.2025.84348.3837
Abstract
Objectives: Clavicle fractures are the most common injuries of the scapular girdle. These fractures can be treated surgically using two primary methods: open reduction with internal plate fixation or intramedullary fixation. Plate fixation can be performed in two commonly used positions: anterior and superior. This randomized, double-blind clinical trial aimed to compare the outcomes of superior versus anterior plate fixation in the treatment of clavicle fractures.
Methods: This randomized, double-blind clinical trial focused on patients with clavicle fractures who underwent internal plate fixation between 2020 and 2021. The patients were divided into two groups: the anterior group, which received internal plate fixation using an anterior-inferior plating technique, and the superior group, which received internal plate fixation using a superior plating technique.
Results: A total of 75 patients were included in this study, with an average age of 42.32 years in the anterior group and 40.92 years in the superior group. Sixty-three (84%) of the patients were male, and 39 (52%) of the patients sustained their fractures as a result of vehicle accidents. Patients in the anterior group reported a satisfaction score of 96.68 (±1.13), compared to 58.08 (±12.32) in the superior group (p<0.05). Ten (20%) patients in the superior group reported plate-related irritation after three months, while only four (16%) patients in the anterior group experienced irritation (p<0.05). Two patients in the superior group developed non-union and required re-surgery. No cases of infection or pneumothorax occurred due to the surgery. Out of the 75 patients included in the study, two in the superior group and one in the anterior group reported a loss of function at the three-month follow-up.
Conclusion: Anterior plating is usually correlated with higher rates of patient satisfaction.
        Level of evidence: I
Keywords
Bone plates
Clavicle fractures
Fracture fixation
Orthopedic procedures
Postoperative complications
Quality of life
Surgical technique
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 4
April 2026
Pages 285-294

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