Combination of MIPO and WALANT procedure versus ORIF and general anesthesia in midshaft clavicle fracture: a prospective comparative cohort study.

PURPOSE: Midshaft fractures are the most common type of clavicle fractures, which make up around 3% of all adult fractures. Although nonsurgical approaches have historically been used to treat these fractures, new research highlights the need for surgery. This study aims to determine the effectiveness of treating displaced midshaft clavicle fractures with a combination of minimally invasive plate osteosynthesis (MIPO) with wide-awake local anesthetic (WALANT) or open reduction and internal fixation (ORIF) with general anesthesia (GA).

METHODS

In this prospective cohort study, 30 patients requiring surgical intervention for clavicle fractures were divided into two groups. Group A underwent MIPO with WALANT, and Group B underwent ORIF with GA. Patients were followed 18-24 months after surgery, with baseline characteristics balanced between the groups.

RESULTS

Group A demonstrated advantages in incision length, amount of bleeding, and surgery duration compared to the other group. However, wound complications, union rates, and pain levels were similar in both groups.

CONCLUSION

With comparable surgical outcomes, the MIPO with WALANT technique offers a less invasive, patient-friendly, and economical approach for healthcare systems. It is potentially one of the standard techniques for treating clavicle fractures in the midshaft.

LEVEL OF EVIDENCE: II.