Abstracts / Injury Extra 41 (2010) 167-196 189 have found that they sometimes fit better when reversed (i.e. when the medial end of the plate is applied laterally and the lateral end of the plate is applied medially). The purpose of this study was to quantify this. Methods: 50 human cadaveric clavicles and all the plates on the Acumed set were photographed from a fixed distance. Using digital imaging software the plates were superimposed over each clavicle to determine the quality of fit. The

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... t was defined as good if there was no overhang of the plate either anteriorly or posteriorly, fair if there was overhang either anteriorly or posteriorly and poor if there was either overhang both posteriorly and anteriorly or if any of the screw-holes missed the bone. Results: We found that 94% of the plates had a good and 4% had a fair fit when superimposed over the midshaft of the clavicles in the orientation suggested by the manufacturer. If the plates were placed more laterally in this orientation the fit was universally poor. The fit was much better when the plates were reversed: 62% had a good fit and a further 30% had a fair fit. Conclusions: Our results show that the previous literature which suggests a poor fit may be inaccurate. The option of reversing the plates should be considered by the surgeon particularly when plating more lateral fractures. (L.K. Milnes). Our shoulder unit has successfully treated 12 patients for fracture of the clavicle as day cases. In all cases an Acumed locking plate was used. Five were primary fixations and seven were for non-unions. The age range was 17-52 years with a median of 38.5 years. Five were right and seven were left clavicles. There were five female and seven male patients. All were operated upon by the same surgeon. No bone graft was used in any of the operations including those done for non-unions. In some patients the plates fit better when used in reverse (medial end placed laterally and lateral end placed medially). All fractures united and excellent functional results were achieved.