Mechanical failure of plate breakage after open reduction and plate fixation of displaced midshaft clavicle fracture - a possible new risk factor: a case report

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...

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Bibliographic Details
Published in:Journal of medical case reports 2019-04, Vol.13 (1), p.127-127, Article 127
Main Authors: Batash, Ron, Debi, Ronen, Grinberg, Dan, Shema, Maayan, Elbaz, Avi, Benedict, Yeshaiau
Format: Article
Language:English
Subjects:
Bending stresses
Bridge construction
Care and treatment
Case Report
Case reports
Case studies
Clavicle
Complications and side effects
Failure
Failure analysis
Fracture repair
Fractures
Fractures (Injuries)
Internal fixation
Open reduction and plate fixation
Patient outcomes
Physical therapy
Plate breakage
Postoperative complications
Risk factors
Surgery
Systematic review
Transplants & implants
Trauma
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Summary: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. 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. 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.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-019-2046-3