Dual mini-plate versus mini-plus-standard plate fixation for displaced medial clavicle fractures: A retrospective...

ObjectiveTo compare clinical and perioperative outcomes of dual mini-plate fixation with mini-plus-standard plate fixation for displaced medial clavicle fractures.MethodsWe retrospectively reviewed 30 patients treated surgically between October 2016 and March 2023. Group A (n=16) underwent dual mini-plate fixation using two 2.7-mm low-profile plates, whereas Group B (n=14) underwent mini-plus-standard plate fixation using a contoured inverted distal clavicle locking plate together with a 2.7-mm mini-plate. Operative time, blood loss, a study-specific intraoperative construct-stability assessment, fracture healing, implant-related complications, Constant-Murley score, Rockwood score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score were compared.ResultsOperative time was shorter with dual mini-plate fixation (48.8±11.8 vs. 59.5±13.7 min; P=0.029), and stable fixation on the intraoperative assessment was more frequent (15/16 [93.8%] vs. 8/14 [57.1%]; Fisher exact P=0.031). Blood loss and radiographic healing time were similar between groups. Implant-related skin irritation with persistent local discomfort occurred in 0/16 patients in Group A and 6/14 (42.9%) in Group B (P=0.005); symptoms improved after hardware removal. Constant-Murley and Rockwood scores were comparable, whereas the final DASH score was lower in Group A (1.6±0.3 vs. 2.1±0.4; P<0.001).ConclusionBoth constructs achieved fracture union and good shoulder function in this small retrospective series. Dual mini-plate fixation was associated with shorter operative time, greater intraoperative construct stability, and less implant prominence-related irritation than the mini-plus-standard plate construct. These findings should be interpreted in view of the nonrandomized design and limited sample size.