ORIF Clavicle: Single Plating or Dual Mini-Fragment Plates?

A high-visibility study that might cause surgeons to change approaches has serious issues

Editor’s Note: Sometimes, we’ll cover an article we think is likely to cross your desk, but whose message we have reservations about. Here’s one. — SSL

What’s the Claim?

A retrospective, comparative study of patients who underwent ORIF of displaced, midshaft clavicle fractures using one of three techniques — orthogonal, dual, mini-fragment plates; a single superior plate; or a single anterior plate — suggested the risk of reoperation was much lower in the dual mini-frag plate group, with no differences in the risk of nonunion across the techniques.

We’re concerned that the main finding (which the authors emphasized using a lot of splashy language like “nearly 8-fold lower risk of reoperation”) may not be reliable. We believe using that “finding” — as the authors did — to suggest that more clavicle fracture surgery should be done is not appropriate.

This study offers a tutorial in why close reading matters.

How’s It Stack Up?