A comparison of clinical and radiological outcomes of minimally invasive and conventional plate osteosynthesis for midshaft clavicle fractures

Thirty patients with displaced midshaft clavicle fractures were prospectively enrolled in this study. Fifteen were randomly assigned to the minimally invasive plate osteosynthesis group and 15 to the conventional plate osteosynthesis group. Constant score, visual analog scale satisfaction score, operative time, scar length, and complications, including hypoesthesia, were evaluated at least 1 year postoperatively to determine functional outcomes and time to bone union as a radiological outcome. Factors related to bone union, including the gap in-terval between fracture fragments and the number of fracture fragments, were also evaluated. The Constant score and the visual analog scale satisfaction score were higher in the minimally invasive plate osteosynthesis group than in the conventional plate osteosynthesis group; however, there was no significant difference between the groups in these scores or in the time to bone union (all P>.05). Hypoesthesia was the only complication, and its incidence was not different between the groups (P=.249). However, operative time (52.33±13.87 vs 110.33±25.39 minutes, P<.001) and scar length (64.95±3.19 vs 99.39±15.98 mm, P<.001) were significantly shorter in the minimally invasive plate osteosynthesis group than in the conventional plate osteosynthesis group, respectively. In the minimally invasive plate osteosynthesis group, time to bone union was significantly correlated with the gap interval (P=.004) and the number of fracture fragments (P=.002). Minimally invasive plate osteosynthesis showed some superiority over conventional plate fixation for midshaft clavicle fractures, having a shorter operative time and scar length. The time to bone union was influenced by the reduction status and the number of fracture fragments in the minimally invasive plate osteosynthesis group.