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Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures
BACKGROUND: The rate of operative fixation of acute midshaft clavicle fractures has exponentially increased in recent years; however, the rate of reoperation for symptomatic hardware removal remains high and the optimal fixation strategy unknown. This systematic review aimed to summarize available e...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527487/ https://www.ncbi.nlm.nih.gov/pubmed/36199514 http://dx.doi.org/10.1177/17585732211002495 |
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author | Sheth, Ujash Fernandez, Claire E Morgan, Allison M Henry, Patrick Nam, Diane |
author_facet | Sheth, Ujash Fernandez, Claire E Morgan, Allison M Henry, Patrick Nam, Diane |
author_sort | Sheth, Ujash |
collection | PubMed |
description | BACKGROUND: The rate of operative fixation of acute midshaft clavicle fractures has exponentially increased in recent years; however, the rate of reoperation for symptomatic hardware removal remains high and the optimal fixation strategy unknown. This systematic review aimed to summarize available evidence for dual plating of acute displaced midshaft clavicle fractures. METHODS: EMBASE, MEDLINE, and PubMed searches identified clinical studies evaluating dual plate fixation of acute midshaft clavicle fractures. Pooled analysis was performed using a random-effects model in RevMan 5.3. RESULTS: Eleven studies including 672 patients were included. Hardware removal occurred in 4.4% and 12.3% of patients undergoing dual and single plate fixation, respectively. Compared to single plating, dual plating had significantly lower odds of hardware removal (P = 0.001) with no difference in union rates. There were no significant differences in reoperation (excluding hardware removal), complications, and patient-reported outcomes between the two groups (P > 0.05). CONCLUSIONS: This study suggests that dual plating of acute displaced midshaft clavicle fractures may lead to lower rates of reoperation for symptomatic hardware removal without compromising fracture healing. Ultimately, well-designed randomized trials are needed to further investigate the findings from this systematic review. |
format | Online Article Text |
id | pubmed-9527487 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-95274872022-10-04 Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures Sheth, Ujash Fernandez, Claire E Morgan, Allison M Henry, Patrick Nam, Diane Shoulder Elbow Shoulder BACKGROUND: The rate of operative fixation of acute midshaft clavicle fractures has exponentially increased in recent years; however, the rate of reoperation for symptomatic hardware removal remains high and the optimal fixation strategy unknown. This systematic review aimed to summarize available evidence for dual plating of acute displaced midshaft clavicle fractures. METHODS: EMBASE, MEDLINE, and PubMed searches identified clinical studies evaluating dual plate fixation of acute midshaft clavicle fractures. Pooled analysis was performed using a random-effects model in RevMan 5.3. RESULTS: Eleven studies including 672 patients were included. Hardware removal occurred in 4.4% and 12.3% of patients undergoing dual and single plate fixation, respectively. Compared to single plating, dual plating had significantly lower odds of hardware removal (P = 0.001) with no difference in union rates. There were no significant differences in reoperation (excluding hardware removal), complications, and patient-reported outcomes between the two groups (P > 0.05). CONCLUSIONS: This study suggests that dual plating of acute displaced midshaft clavicle fractures may lead to lower rates of reoperation for symptomatic hardware removal without compromising fracture healing. Ultimately, well-designed randomized trials are needed to further investigate the findings from this systematic review. SAGE Publications 2021-03-17 2022-10 /pmc/articles/PMC9527487/ /pubmed/36199514 http://dx.doi.org/10.1177/17585732211002495 Text en © 2021 The British Elbow & Shoulder Society https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Shoulder Sheth, Ujash Fernandez, Claire E Morgan, Allison M Henry, Patrick Nam, Diane Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title | Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title_full | Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title_fullStr | Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title_full_unstemmed | Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title_short | Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures |
title_sort | are two plates better than one? a systematic review of dual plating for acute midshaft clavicle fractures |
topic | Shoulder |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527487/ https://www.ncbi.nlm.nih.gov/pubmed/36199514 http://dx.doi.org/10.1177/17585732211002495 |
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