Evidence map›Paper›PMID 41146821›Full record

ReviewCureus2025

Plate Fixation Versus Intramedullary Nailing for Displaced Clavicular Shaft Fractures: An Updated Meta-Analysis of Randomized Controlled Trials.

Daniel P Oar, Jason S DeFrancisis, Alex Abouafech, Nicholas Lorenz, Dante DiSilvestro, Alexander Macfarlane

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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

6 authors.

Daniel P OarOrthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Jason S DeFrancisisOrthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Alex AbouafechGeneral Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Nicholas LorenzOrthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Dante DiSilvestroMedicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Alexander MacfarlaneOrthopaedic Surgery, Trinity Orthopaedics of Western New York, Buffalo, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clavicle fractures are a common injury encountered in orthopedic practice, particularly among young, active individuals and older adults with multiple comorbidities. Severely displaced fractures are often treated surgically, with plate fixation (PF) and intramedullary nailing (IMN) representing the two most widely accepted approaches. While both techniques are commonly used, it remains relatively unclear which method yields superior post-operative outcomes. This meta-analysis aims to compare PF and IMN in the surgical management of clavicle fractures by investigating functional recovery scores and perioperative outcomes. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Studies included in this meta-analysis comprised patients with clavicle fractures treated with either PF or IMN who reported at least one of the following outcomes: Constant-Murley score; Disabilities of the Arm, Shoulder, and Hand (DASH) score; union time; incision length; or operative time. Seven RCTs, involving a total of 455 patients, met the inclusion criteria. The National Institute of Health Quality Assessment Tool was used for risk of bias assessment, and random-effects models were used for data analysis. No significant differences were found between PF and IMN in terms of the Constant-Murley score, DASH score, union time, and operative time, with an overall effect size of -2.67, 4.32, 0.66, and 2.80, respectively. However, IMN was associated with a significantly shorter incision length, with an overall effect size of 6.70, highlighting its minimally invasive nature. Heterogeneity was moderate to high for all outcome measures (I² range: 61.0%-96.2%), indicating appreciable variability between studies. While both techniques are proven to be effective, the choice of surgical method should be tailored to individual patient needs, surgeon experience, and specific fracture characteristics. As variability in outcomes and practice patterns persists, additional high-quality RCTs are needed to clarify long-term differences in functional recovery and surgical outcomes in the operative management of clavicle fractures.

Indexed as

clavicle fracturesintramedullary nail fixationmeta-analysisopen reduction internal fixationoriforthopaedic surgeryorthopedic surgery

Identifiers

PMID41146821
PMCPMC12553529

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LicenceCC BY
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Registered trials

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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 OpenQuestion graph.