MIPO more advantageous than ORIF in treatment of displaced midshaft clavicle fractures: study

Written By :  Dr Supreeth D R
Published On 2025-11-09 14:45 GMT   |   Update On 2025-11-09 14:46 GMT
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Wang et al conducted a study to evaluate the clinical efficacy and advantages of Minimally Invasive Plate Osteosynthesis (MIPO) for the treatment of displaced midshaft clavicle fractures (DMCFs).

A retrospective case–control study was conducted involving 79 patients with DMCFs. Patients were divided into two groups based on the surgical technique: MIPO (n = 32) and Open Reduction and Internal Fixation (ORIF) (n = 47). Key parameters—including operative time, intraoperative blood loss, incision length, complications, patient satisfaction, and functional recovery outcomes—were compared.

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The key findings of the study were:

• Baseline characteristics were comparable between the two groups, including age (41.66 ± 11.32 years vs. 42.53 ± 11.18 years, p = 0.731), sex distribution (male/ female: 18/14 vs. 31/16, p = 0.383), BMI (23.24 ± 2.21 vs. 23.86 ± 1.74, p = 0.170), smoking history (25.0% vs. 29.8%, p = 0.641), alcohol use (12.5% vs. 21.3%, p = 0.316), hypertension (18.8% vs. 10.6%, p = 0.798), diabetes mellitus (15.6% vs. 14.9%, p = 0.929), injury mechanism (p = 0.406), AO/OTA fracture classification (p = 0.635), and Robinson classification (p = 0.536). No statistically significant differ¬ences were observed in any of these parameters.

• Compared to the ORIF group, the MIPO group demonstrated significantly shorter operative time (54.22 ± 5.14 min vs. 61.15 ± 6.01 min, p < 0.001), reduced intraoperative blood loss (45.44 ± 4.27 mL vs. 52.81 ± 6.60 mL, p < 0.001), and shorter incision length (6.42 ± 0.48 cm vs. 12.25 ± 1.60 cm, p < 0.001).

• Postoperative supraclavicular nerve injury was less frequent in the MIPO group (12.5% vs. 38.3%, p < 0.001) and patient satisfaction was higher (90.6% vs. 72.3%, p = 0.021).

• No significant differences were observed in functional outcomes, as assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores.

The authors concluded – “Both MIPO and ORIF are effective surgical options for the management of DMCFs. Although functional recovery outcomes were comparable between the two techniques, MIPO demonstrated clear advantages in terms of reduced surgical trauma, accelerated postoperative recovery, lower complication rates, and higher patient satisfaction. These findings support the wider clinical adoption of MIPO, particularly in healthcare settings that emphasize minimally invasive approaches and enhanced recovery protocols.”

Further reading:

Clinical outcomes of minimally invasive plate osteosynthesis in the management of displaced midshaft clavicle fractures: a case-control study

Wang et al. BMC Musculoskeletal Disorders (2025) 26:905

https://doi.org/10.1186/s12891-025-08995-0

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Article Source : BMC Musculoskeletal Disorders

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