Morphologic profiles of comminuted midshaft clavicle fractures: a preliminary study.

INTRODUCTION

Previous literature lacks parametric analysis of clavicle fracture morphology. The aim of this study was to describe the features of comminuted midshaft clavicle fracture in surgically treated patients.

METHODS

A total of 117 consecutive patients with an acute displaced midshaft clavicular fracture were retrospectively evaluated. All fractures underwent open reduction and internal fixation. The radiographic and surgical data of all patients were collected.

RESULTS

There were 39 AO type B fractures and 78 type C fractures. In the overall sample, the average proximal main fragment measured 8.41 ± 1.40 cm in length, which was greater than the distal main fragment of 5.34 ± 0.94 cm on the radiograph. From the three-dimensional CT images, 104/117 patients (88.89%) had coronal plane fracture lines. During the operation, 94/117 patients (80.34%) were seen to have one or more fragments in the antero-inferior quadrant only. 102 of 117 patients (87.18%) were found to have a constant segment for anatomic reduction. For those anatomic reduction were available, 98 (96.08%) had cortical contact of main fracture fragments in the posterior-superior quadrant of the fracture region.

CONCLUSIONS

Comminuted midshaft clavicle fracture frequently had coronal plane fracture lines. Wedge-shaped or multifragmentary fragments were predominantly located anteriorly or inferiorly. In the posterior-superior portion of the clavicle, cortical contact was found to guide reduction.