Dataset for Plate Fixation versus Nonoperative Treatment for Displaced Midshaft Clavicular Fracture Patients: A Systematic Review with Meta-Analysis of Randomised Controlled Trials.

Adult clavicle fractures account for 4% of all fractures and are a common injury. The question of whether an operation should be considered a first option in the intervention is still up for dispute. The purpose of this study is to determine whether operation results in better non-union rate, mean time to union and return to work, early and late functional outcome, and complications as compared to conservative treatment. We include only randomized control trials from several databases including, MEDLINE, EMBASE, Clinicatrials.gov, and Google Scholar through December 2023. The quality of the studies was appraised using Cochrane Risk of Bias tools and we present the analysis using GRADE summary finding table. We included 23 studies for this review. In total there were 2116 patients with displaced midshaft clavicular fracture. For the incidence of non-union outcomes, we reviewed all 22 included studies. Plate fixation results in a slight reduction in non-union cases (Odds Ratio [OR] 0.13, 95% Confidence Interval [95% CI] 0.12 to 0.31). Mean time to union and return to work maybe better in plate fixation group with mean difference 0.61 (95%CI: -0.83 to -0.39) and 0.38 (95%CI: -0.74 to -0.02) respectively. Early functional score showed better results with plate fixation showing a slight reduction in DASH Score at 6 Weeks with mean difference 0.37 (95%CI: -0.57 to -0.17). However, in term of long-term functional outcomes both in DASH and Constant score at 12 months, plate fixation did not show better results with mean difference of 0.04 (95%CI: -0.54 to 0.45) and 0.46 (95%CI: 0.1 to 0.81). Although only RCTs were analyzed, the quality of several studies was low with high risk of bias that could give uncertainty to the results. In this study, plate fixation outperformed nonoperative treatment in terms of union rate and early functional outcomes; as such, it is a good option for patients whose activities are in high demand. This study is not funded and registered in PROSPERO (CRD42023491880).