Risk Factors for Implant Removal After Surgical Fixation of Midshaft Clavicle Fractures

Peter J. Ostergaard, Matthew J. Hall, Grace Xiong, Dafang Zhang, Brandon E. Earp

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Midshaft clavicle fractures are common injuries that traditionally have been managed nonoperatively. However, recent literature has shown lower rates of nonunion and improved patient-reported outcomes with surgical management. The rate of implant removal after surgical fixation varies across the literature from 5% to 82%, depending on the method of fixation. We performed a retrospective review of all patients who underwent open reduction and internal fixation (ORIF) with plate-and-screw constructs for midshaft fractures of the clavicle at 2 level I trauma centers to determine the rate of implant removal and identify variables associated with implant removal. We collected all patient-, injury-, and treatment-specific factors as well as information on reoperation for removal of implants. Bivariate analysis and multivariable logistic regression analysis were used to assess whether explanatory factors were associated with removal of implants after ORIF for midshaft clavicle fractures. Of the 146 patients who were treated with ORIF for midshaft clavicle fractures with plate-and-screw constructs, 41 (28%) underwent removal of the implant. The median follow-up was 836 days (interquartile range, 457-1567 days). Variables associated with increased risk of implant removal included anterior plate position (odds ratio, 5.32; 95% CI, 2.01-14.1) and number of holes in the plate (odds ratio, 1.28; 95% CI, 1.00-1.63). These results question whether anterior plating results in less implant prominence and less subsequent removal of implants.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalOrthopedics
Volume45
Issue number4
DOIs
StatePublished - Jul 2022

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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