Dual orthogonal plating of clavicle fractures may provide greater stiffness and strength than unilateral plate constructs and allow the use of lower-profile plates. We aim to biomechanically compare three clavicle plating constructs in a comminuted clavicle fracture model. Fifteen clavicle sawbones were osteotomised, simulating a comminuted midshaft fracture and allocated to either: group 1, single superior plate (3.5 mm superior plate); group 2, combination plating (3.5 mm superior plate, 2.8 mm anterior plate) and group 3, dual mini-plates (two 2.8-mm orthogonal mini-plates). Specimens were biomechanically tested under torsion and cantilever bending. Construct stiffness (Nm/degree) and load to failure (Nm) were measured. Group 2 had higher torsional (0.70 vs. 0.60 Nm/deg, p = 0.017) and cantilever bending stiffness (0.61 vs. 0.51 Nm/deg, p = 0.025) than group 1. Group 3 had lower cantilever bending stiffness (0.39 vs. 0.51 Nm/deg, p < 0.004) and load to failure (40.87 vs. 54.84 Nm, p < 0.01) than group 1. All dual plate constructs that catastrophically failed did so from fracture at the lateral ends of the plates. Single plate constructs failed due to plate bending. Dual orthogonal fixation with mini-plates demonstrated lower stiffness and strength than traditional superior plating. The addition of an anterior mini-plate to a traditional superior plating improved construct stiffness and may have a role in patients seeking early return to activity. Basic science biomechanical study

中文翻译：

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单与双正交钢板治疗粉碎性锁骨中段骨折：生物力学研究。


锁骨骨折的双正交钢板可以比单侧钢板结构提供更大的刚度和强度，并允许使用较小轮廓的钢板。我们的目的是在锁骨粉碎性骨折模型中从生物力学角度比较三种锁骨电镀结构。对 15 个锁骨锯骨进行截骨，模拟粉碎性中段骨折，并分配给以下任一组：第 1 组，单上钢板（3.5 mm 上钢板）；第 1 组，单上钢板（3.5 mm 上钢板）；第 2 组，组合钢板（3.5 mm 上钢板，2.8 mm 前钢板）和第 3 组，双迷你钢板（两个 2.8 mm 正交迷你钢板）。样本在扭转和悬臂弯曲下进行了生物力学测试。测量了结构刚度（Nm/度）和破坏载荷（Nm）。第 2 组的扭转刚度（0.70 vs. 0.60 Nm/deg，p = 0.017）和悬臂弯曲刚度（0.61 vs. 0.51 Nm/deg，p = 0.025）高于第 1 组。第 3 组的悬臂弯曲刚度较低（0.39 vs. 0.39）。 0.51 Nm/deg, p < 0.004) 和失效载荷 (40.87 vs. 54.84 Nm, p < 0.01) 均高于第 1 组。所有灾难性失效的双板结构均因板侧端断裂而导致。单板结构由于板弯曲而失败。与传统的优质电镀相比，使用迷你板的双正交固定具有较低的刚度和强度。在传统的高级钢板中添加前部微型钢板可改善结构刚度，并且可能对寻求早期恢复活动的患者发挥作用。基础科学生物力学研究