Plate Fixation Versus Intramedullary Nailing for Displaced Clavicular Shaft Fractures: An Updated Meta-Analysis of...

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Skeletal Repair

Background:

• Clavicle fractures are common, especially in young athletes and older adults.
• Surgical options for displaced fractures include plate fixation (PF) and intramedullary nailing (IMN).
• Optimal surgical technique for clavicle fractures remains debated.

Purpose of the Study:

• To compare the efficacy of PF versus IMN for surgical clavicle fracture management.
• To investigate differences in functional recovery and perioperative outcomes.
• To provide evidence-based guidance for surgical decision-making.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Included studies compared PF and IMN for clavicle fractures.
• Analyzed outcomes included Constant-Murley score, DASH score, union time, incision length, and operative time.

Main Results:

• No significant differences found between PF and IMN for functional scores (Constant-Murley, DASH), union time, or operative time.
• Intramedullary nailing (IMN) demonstrated a significantly shorter incision length compared to plate fixation (PF).
• High heterogeneity was observed across all outcome measures (I² range: 61.0%-96.2%).

Conclusions:

• Both PF and IMN are effective surgical treatments for clavicle fractures.
• IMN offers a minimally invasive advantage with shorter incisions.
• Treatment choice should be individualized based on patient factors, surgeon expertise, and fracture patterns.