Clinical outcomes of minimally invasive plate osteosynthesis in the management of displaced midshaft clavicle fractures: a case-control 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 treated at our institution between January 2021 and December 2024. 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. 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. While both surgical techniques yielded comparable functional recovery, MIPO demonstrated distinct intraoperative and early postoperative advantages, including shorter incisions, less blood loss, fewer nerve-related complications, and higher patient satisfaction. These findings support the clinical utility and therapeutic efficacy of MIPO in the management of DMCFs.