Acta Orthopaedica et Traumatologica Turcica
Research Article

Clinical outcome and operative cost comparison: Locked compression plate versus reconstruction plate in midshaft clavicle fractures

1.

Department of Orthopaedic Surgery, University Malaya, School of Medicine, Lembah Pantai, Kuala Lumpur, Malaysia

AOTT 2020; 54: 483-487
DOI: 10.5152/j.aott.2020.19219
Read: 1175 Downloads: 440 Published: 28 October 2020

Objective: The aim of this study was to compare the clinical outcomes and operative cost of a locked compression plate (LCP) and a nonlocked reconstruction plate in the treatment of displaced midshaft clavicle fracture.

Methods: From January 2013 till March 2018, a total of 55 patients with acute unilateral closed midshaft clavicle fracture were treated with either a 3.5-mm pre-contoured LCP [32 patients; 25 men and 7 women; mean age: 35 years (range: 19-63 years)] or a 3.5-mm nonlocked reconstruction plate [23 patients; 20 men and 3 women; mean age: 31.4 years (range: 17-61 years)]. The clinical outcomes in terms of fracture union, Quick Disability of Arm, Shoulder and Hand (DASH) score, implant irritation, failure rate, and reoperation rate were evaluated retrospectively. The patient billing records were reviewed to obtain primary operation, reoperation, and total operative cost for midshaft clavicle fracture. These values were analyzed and converted from Malaysia Ringgit (RM) to United States Dollar (USD) at the exchange rate of RM 1 to USD 0.24. All patients were followed up for at least one-year duration.

Results: The mean time to fracture union, implant irritation, implant failure, and reoperation rate showed no significant difference between the two groups of patients. The mean Quick DASH score was significantly better in the reconstruction plate group with 13 points compared with 28 points in the LCP group (p=0.003). In terms of total operative cost, the LCP group recorded a cost of USD 391 higher than the reconstruction plate group (p<0.001).

Conclusion: The 3.5-mm reconstruction plate achieved not only satisfactory clinical outcomes but was also more cost-effective than the LCP in the treatment of displaced midshaft clavicle fractures.

Level of Evidence: Level III, Therapeutic study

Cite this article as: Gan JT, Chandrasekaran SK, Tuan Jusoh TB. Clinical outcome and operative cost comparison: Locked compression plate versus reconstruction plate in midshaft clavicle fractures. Acta Orthop Traumatol Turc 2020; 54(5): 483-7

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ISSN 1017-995X EISSN 2589-1294