(Carsten Englert and Sebastian Dendorfer, 01. July, 2009 )
From the clinical point of view, superior plate fixation of clavicular midshaft fracture is easy in comparison to the anterior plate position on the clavicular. However, in multiple fragment fractures or in cases with a diagonal fracture line in the mid region of the clavicle failures of superior plate stabilization have been reported. Mostly screw pull-outs staring from medial have been observed. That raises the question, if the superior plate position for clavicle midshaft fractures shall only be used for simple (right angle) fracture types. Both clinical as well as biomechanical aspects will be discussed in this talk. The loading conditions on the bone-implant construct are evaluated during activities of daily living using the AnyBody Modeling System. Following this, a CT based Finite Element Model is loaded with a complex load case including all muscle forces acting on the clavicle and the influence of the different fracture types is investigated. The implications on clinical praxis will be discussed.
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