Open Access

Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials

  • Authors:
    • Weina Ju
    • Sayid Omar Mohamed
    • Baochang Qi
  • View Affiliations

  • Published online on: July 13, 2020     https://doi.org/10.3892/etm.2020.9002
  • Pages: 2783-2793
  • Copyright: © Ju et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A number of meta‑analyses have compared clinical outcomes following plate vs. intramedullary fixation for midshaft clavicle fractures (MSCF), but with conflicting results. There is a requirement for updated level‑1 evidence to guide clinicians managing MSCF. The aim of the present systematic review and meta‑analysis was to compare clinical outcomes following plate vs. intramedullary fixation of MSCF. The PubMed, Scopus, BioMed Central, Cochrane Central Register of Controlled Trials and Google Scholar databases were searched for records added until 1st July 2019. A total of 10 randomised controlled trials (RCTs) were included. Shoulder function was assessed using the Constant‑Murley Shoulder Outcome questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). There was no statistically significant difference in Constant‑Murley scores between plate and intramedullary fixation [Mean difference (MD)=0.75; 95% CI: ‑2.49 to 3.99; P=0.65; I2=85%]. Similarly, there was no statistically significant difference in DASH scores between the two groups (MD=1.55; 95% CI: ‑1.12 to 4.23; P=0.26; I2=89%). There was no statistically significant difference in complications requiring non‑routine surgery between plate and intramedullary fixation [risk ratio (RR)=1.80, 95%CI: 0.80‑4.05, P=0.15; I2=0%]. There was an increased risk of complications that did not require non‑routine surgery with plate fixation as compared to intramedullary fixation (RR=2.38, 95%CI: 1.22‑4.62, P=0.01; I2=70%). Plate fixation was also associated with an increased risk of infection and complications of cosmetic dissatisfaction. The present results indicated no difference in long‑term functional outcomes between plate and intramedullary fixation of MSCF. Plate fixation was associated with an increased risk of complications not requiring non‑routine surgery. Further high‑quality RCTs shall strengthen the evidence on this subject.

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September-2020
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Spandidos Publications style
Ju W, Mohamed SO and Qi B: Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials. Exp Ther Med 20: 2783-2793, 2020
APA
Ju, W., Mohamed, S.O., & Qi, B. (2020). Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials. Experimental and Therapeutic Medicine, 20, 2783-2793. https://doi.org/10.3892/etm.2020.9002
MLA
Ju, W., Mohamed, S. O., Qi, B."Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials". Experimental and Therapeutic Medicine 20.3 (2020): 2783-2793.
Chicago
Ju, W., Mohamed, S. O., Qi, B."Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials". Experimental and Therapeutic Medicine 20, no. 3 (2020): 2783-2793. https://doi.org/10.3892/etm.2020.9002