Does supine positioning improve the surgical treatment of shaft fractures of the clavicle?

Surgical management of diaphyseal clavicle fractures has increased in recent years. It is well established that upright radiographs more accurately assess fracture displacement compared to those taken in the supine position. This study investigates the influence of the supine position during surgical treatment of these fractures. A retrospective study was conducted on 22 patients: 11 operated in the supine position (Group A) and 11 in the beach chair position (Group B). Demographic data, quality of fracture reduction, surgical time, and operative room occupancy time were analyzed. Patients were comparable in terms of age, sex, and fracture type. The median follow-up was 7 months (range: 3-12). The operative room occupancy time was 120 minutes (range: 85-140) in Group A versus 180 minutes (range: 170-185) in Group B, showing a statistically significant difference (p < 0.01). Surgical time was 80 minutes (range: 58-95) in Group A compared to 100 minutes (range: 90-125) in Group B (p < 0.05). Satisfactory fracture reduction was achieved in all 11 patients in Group A and in 8 patients in Group B (p = 0.0104). Supine positioning for osteosynthesis of diaphyseal clavicle fractures appears to be a favorable option due to advantages in fracture reduction and patient positioning, without an observed increase in complications.