Low-profile 2.7 mm VA-LCP plates vs. 3.5 mm LCP plates for midshaft clavicle osteosynthesis: a retrospective comparison

PURPOSE: Implant related irritation and subsequent removal are one of the main disadvantages of clavicle plate osteosynthesis. 2.7 mm VA-LCP clavicle plates with a lower profile were introduced in recent years, with the aim to improve fit and reduce plate prominence. This study aims to investigate whether this leads to a lower implant removal rate compared to the older 3.5 mm LCP clavicle plates. METHODS: All patients that underwent single-plate osteosynthesis for midshaft clavicle fractures between 2019 and 2024 in a Swiss level I trauma-center were included. Patients were categorized into two treatment groups: DePuy Synthes 3.5 mm LCP clavicle plates or DePuy Synthes 2.7 mm VA-LCP clavicle plates. Treatment groups were compared regarding healing, complications, and removal rate. RESULTS: 101 patients were included, 54 with a 2.7 mm VA-LCP plate, and 47 with a 3.5 mm LCP plate. There were no significant differences in implant removal due to hardware irritation (44% versus 49%), overall reintervention rate (46.3% versus 53.2%, p = 0.49), infection (0% versus 4.3% p = 0.21), and refractures (1.9% versus 6.4%, p=0.34). All fractures healed in both groups. CONCLUSION: Newer 2.7 mm VA-LCP clavicle single plating shows similar results in terms of complication and healing rates compared to older 3.5 mm LCP plating. Despite the design aiming for reduced plate-prominence, it does not demonstrate a significant reduction in removal rates in this study. Further studies are needed to ascertain the generalizability of results.