26dkou165 10.3205/26dkou165 urn:nbn:de:0183-26dkou1653 Meeting Abstract Lecoultre Lecoultre Yannic Y

Universität Luzern, Luzern, Schweiz LUKS, Luzern, Schweiz

author Van de Wall Van de Wall Bryan B

Universität Luzern, Luzern, Schweiz LUKS, Luzern, Schweiz

author Diwersi Diwersi Nadine N

Kantonsspital Obwalden, Sarnen, Schweiz

author Pfarr Pfarr Steffen S

Spital Schwyz, Schwyz, Schweiz

author Galliker Galliker Beat B

LUKS Sursee, Sursee, Schweiz

author Pastor Pastor Torsten T

LUKS Wolhusen, Wolhusen, Schweiz

author Babst Babst Reto R

Universität Luzern, Luzern, Schweiz LUKS, Luzern, Schweiz

author Link Link Björn-Christian BC

Universität Luzern, Luzern, Schweiz LUKS, Luzern, Schweiz

author Beeres Beeres Frank F

Universität Luzern, Luzern, Schweiz LUKS, Luzern, Schweiz

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 165 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Schultertrauma Berlin 20261020 20261023 DKOU26_Abs_2077 TextObjectives and questions: Low-profile double-plating has been introduced as an alternative to single-plate osteosynthesis of midshaft clavicle fractures, aiming to reduce implant-related irritation and thereby the need for re-interventions. A multicentre prospective natural experiment was initiated to compare both techniques in clinical practice. This is a preliminary analysis of outcomes available after three years of enrolment and follow-up.Material and methods: Adult patients undergoing operative fixation of midshaft clavicle fractures at the study centres were treated with either conventional superior single plating or low-profile double-plating constructs, according to each centre’s standard of care. Consequently, the geographical location of the accident served as the allocation mechanism. The primary outcome was reoperation within two years. Secondary outcomes included implant-related irritation, implant failures, operative time, and patient-reported function.Results: By January 2026, 74 patients had completed 2-year, and 134 patients 1-year follow-up. Re-operations within two years were significantly lower in the double-plating group compared to single-plating (25.0% vs 59.5%, p = 0.006). This was mainly attributable to implant-related irritation, which was consistently more frequent in single-plating and increased over time, reaching 69% at final follow-up compared to 34% in double-plating. Implant failures were equally rare in both groups (5.3% double vs 4.3% single plating after 1 year, p = 0.99); notably, only 2 needed revision-osteosynthesis. Operative time was significantly shorter for double-plating (68 vs 86 min median, p < 0.001). At 12 weeks, single plating was associated with lower disability scores (9.1 vs 15.9 median, p = 0.016), although this difference attenuated in subgroup analysis excluding patients with concomitant injuries. Functional outcomes showed no significant nor clinically meaningful differences at one year (QuickDASH 2.3 vs 4.5 median, p = 0.36). No mal/non-unions were observed after 12 months, and no refractures after implant removal were reported to date.Discussion and conclusions: This preliminary analysis suggests that low-profile double-plating is associated with substantially lower re-operation and implant irritation rates compared to single plating, without an increased risk of failure and with similar mid-term functional outcomes. Continued follow-up is warranted to confirm these findings at study completion. 0 0 0 0