Comparison of 2 plating techniques for lateral clavicle fractures, using a new standardized biomechanical testing setup

Conservative treatment of lateral clavicle fractures (Neer type II) often ends with unsatisfactory results for patients. Operative treatment is thus gaining acceptance. A retrospective study found success using a double plate technique for these injuries. For the current study, a standardized testing setup was developed to compare the mechanical properties of single versus double plate technique for lateral clavicle fractures. Six synthetic bones were tested for each technique. Neer type IIB fractures were created using computer-aided design (CAD). Fatigue testing was carried out with a cantilever bending test. Parameters measured were cycles undergone, failure load and stiffness at the point of failure. The standardized testing setup was able to provide reproducible failures. The double plate technique lasted about 16,000 more cycles and withstood an additional 22.4 N on average. The new modified standardized testing setup produced reproducible fixation failures for both clavicle fracture fixation techniques. The double plate technique seems to be mechanically superior to the single plate technique