Superior versus anteroinferior plating of displaced midshaft clavicular fracture in patients older than 60 years

OBJECTIVE: To compare superior versus anteroinferior plating for displaced midshaft clavicular fracture in elderly patients. METHODS: We retrospectively compared the functional result, parameters, and perioperative course of displaced midshaft clavicular fracture in 42 patients >60 years treated with a 3.5-mm reconstruction plate placed superiorly versus anteroinferiorly. RESULTS: Groups were similar with regard to age, sex, bone mineral density, cause of injury, and fracture pattern. The superiorly-plated group had a significantly longer operation time and greater blood loss, complications and implant prominence. Constant scores were significantly higher for the anteroinferiorly-plated group than the superiorly-plated group at 3 months postoperatively; however, there was no difference between groups at final follow-up. CONCLUSION: While both anteroinferior and superior plate placement are safe and effective for displaced midclavicular fractures in patients >60 years, the anteroinferior approach involves less operation time, blood loss, complications and implant prominence, and enables faster return to normal activities.