Evidence mapPaperPMID 41288770Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Dual-plating is associated with lower implant removal rates compared with single-plate fixation for midshaft clavicle fractures: a meta-analysis.

Marc Boutros, Guy Awad, Akinkunmi Adio, Jad Lawand, Peter Boufadel, Adam Z Khan, Brian W Hill, John G Horneff, Joseph A Abboud

Abstract readMeta-AnalysisSystematic ReviewComparative Study
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In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Marc BoutrosFaculty of Medicine, Saint Joseph University, Beirut, Lebanon. marceboutros@gmail.com.
Guy AwadFaculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Akinkunmi AdioDepartment of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
Jad LawandThe University of Texas Medical Branch at Galveston, Galveston, USA.
Peter BoufadelDivision of Shoulder and Elbow Surgery, Rothman Orthopaedics, Philadelphia, USA.
Adam Z KhanDepartment of Orthopaedic Surgery, Southern California Permanente Medical Group, Panorama City, CA, USA.
Brian W HillPalm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA.
John G HorneffDepartment of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
Joseph A AbboudDivision of Shoulder and Elbow Surgery, Rothman Orthopaedics, Philadelphia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisplaced midshaft clavicle fractures are often managed operatively, with single-plate fixation serving as the standard approach. Dual-plate fixation has emerged as an alternative, particularly for complex fracture patterns, aiming to reduce hardware-related complications and enhance biomechanical stability. The aim of this study was to compare outcomes and complications following single and dual-plating techniques for midshaft clavicle fractures.

methodsA systematic literature search was performed using PubMed, Scopus, Embase, and Google Scholar through July 20, 2025. Comparative studies evaluating dual- versus single-plate fixation for midshaft clavicle fractures in adults were included. Seven studies met inclusion criteria, including 825 patients with midshaft clavicle fractures. Outcomes assessed included operative time, the American Shoulder and Elbow Surgeons (ASES) score, nonunion rates, other complication rates, implant removal rates, and overall reoperation rates.

resultsDual-plate fixation was associated with significantly lower implant removal rates (risk ratio (RR) = 2.58; 95% CI: 1.45-4.57; p = 0.001) and overall reoperation rates (RR = 2.94; 95% CI: 1.47-5.87; p = 0.002) compared to single-plate fixation. Additionally, a borderline statistically significant reduction in other complications was observed with dual plating (RR = 1.95; 95% CI: 1.01-3.80; p = 0.05), with complication rates of 7.0% versus 19.4%, respectively. No statistically significant differences were found in operative time, ASES scores, or nonunion rates (all p ≥ 0.05).

conclusionDual-plate fixation is associated with significantly lower rates of implant removal and reoperations, and a borderline but clinically significant reduction in other complications, compared with single-plate fixation for midshaft clavicle fractures. These findings suggest that dual plating may offer improved implant-related outcomes without increasing operative time or compromising fracture healing.

Indexed as

Bone PlatesClavicleDevice RemovalFracture Fixation, InternalFractures, BoneHumansOperative TimePostoperative ComplicationsReoperationDual-plate fixationMidshaft clavicle fracturesSingle-plate fixation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.