Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis
Background: Clavicle fractures are among the most common upper limb fractures in adults, with the midshaft region being the most frequently affected site. Minimally invasive plate osteosynthesis (MIPO) has emerged as an alternative to the traditional open reduction and internal fixation (ORIF) techn...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323002657 |
| _version_ | 1797296198454870016 |
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| author | Vitor La Banca, MD Guilherme Henrique Vieira Lima, MD Ana Victoria Palagi Vigano, MD Felipe Fernandes Gonzalez, MD, MSc Henrique de Lazari Schaffhausser, MD Luiz Henrique Oliveira Almeida, MD Luis Gustavo Prata Nascimento, MD, MSc Joel Murachovsky, MD, PhD Roberto Yukio Ikemoto, MD, PhD |
| author_facet | Vitor La Banca, MD Guilherme Henrique Vieira Lima, MD Ana Victoria Palagi Vigano, MD Felipe Fernandes Gonzalez, MD, MSc Henrique de Lazari Schaffhausser, MD Luiz Henrique Oliveira Almeida, MD Luis Gustavo Prata Nascimento, MD, MSc Joel Murachovsky, MD, PhD Roberto Yukio Ikemoto, MD, PhD |
| author_sort | Vitor La Banca, MD |
| collection | DOAJ |
| description | Background: Clavicle fractures are among the most common upper limb fractures in adults, with the midshaft region being the most frequently affected site. Minimally invasive plate osteosynthesis (MIPO) has emerged as an alternative to the traditional open reduction and internal fixation (ORIF) technique, offering potential advantages. The purpose of this study was to conduct a systematic review to explore the results of this technique in the existing literature, with emphasis on the occurrence of surgical complications and functional outcomes and also to provide a comprehensive comparison of MIPO and ORIF in the management of midshaft clavicle fractures. Methods: We conducted a systematic review to evaluate the complication incidence and clinical outcomes of MIPO for midshaft clavicle fractures. We searched PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, the Cochrane Database of Controlled Trials, and the Cochrane Database of Systematic Reviews databases without language or date restrictions. Studies focusing on midshaft clavicle fractures treated with MIPO were included, while other clavicle fractures and nonclinical studies were excluded. The risk of bias was assessed using the Methodological Index for Nonrandomized Studies criteria and the Risk of Bias Tool 2 Cochrane tool. Data synthesis included qualitative analysis, and if applicable, quantitative analysis and meta-analysis. Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines ensured reporting quality. Results: A total of 107 studies were initially identified, after applying inclusion and exclusion criteria, 22 studies were included for data extraction. These studies involved the evaluation of 714 clavicles treated with the MIPO technique. Of the 714 MIPO cases, 11 cases of implant failure, 5 nonunions, 2 infections, and 28 cases with neurological impairment were observed. Quantitative analysis comparing MIPO with ORIF revealed that MIPO had significantly shorter surgery time (mean difference −12.95, 95% confidence interval [−25.27 to −0.63], P = .04) and lower occurrence of numbness (odds ratio 0.29, 95% CI [0.15-0.56], P = .0002) compared to ORIF. Time to bone union, functional outcomes, and other complications were similar between MIPO and ORIF at the final follow-up. An overall moderate risk of bias was found across the studies. Conclusion: The MIPO technique yields good and comparable results to ORIF for midshaft clavicle fractures. Additionally, the MIPO technique may offer advantages such as reduced surgical time and lower chances of neurological impairment. |
| first_indexed | 2024-03-07T21:59:54Z |
| format | Article |
| id | doaj.art-403f9dbb2edd439daa9e76d1cdc85566 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-07T21:59:54Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-403f9dbb2edd439daa9e76d1cdc855662024-02-24T04:55:35ZengElsevierJSES International2666-63832024-03-0182257267Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysisVitor La Banca, MD0Guilherme Henrique Vieira Lima, MD1Ana Victoria Palagi Vigano, MD2Felipe Fernandes Gonzalez, MD, MSc3Henrique de Lazari Schaffhausser, MD4Luiz Henrique Oliveira Almeida, MD5Luis Gustavo Prata Nascimento, MD, MSc6Joel Murachovsky, MD, PhD7Roberto Yukio Ikemoto, MD, PhD8Disciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, Brazil; Instituto Brasil de Tecnologia da Saúde, Rio de Janeiro, RJ, Brazil; Corresponding author: Vitor La Banca, MD, Rua da Consolação, 222 Cj 2002, São Paulo, SP 01302091, Brazil.Disciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, Brazil; Hospital Ipiranga, São Paulo, SP, BrazilInstituto Brasil de Tecnologia da Saúde, Rio de Janeiro, RJ, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, Brazil; Hospital Ipiranga, São Paulo, SP, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, BrazilDisciplina de Ortopedia - Faculdade de Medicina do ABC, Santo André, SP, Brazil; Hospital Ipiranga, São Paulo, SP, BrazilBackground: Clavicle fractures are among the most common upper limb fractures in adults, with the midshaft region being the most frequently affected site. Minimally invasive plate osteosynthesis (MIPO) has emerged as an alternative to the traditional open reduction and internal fixation (ORIF) technique, offering potential advantages. The purpose of this study was to conduct a systematic review to explore the results of this technique in the existing literature, with emphasis on the occurrence of surgical complications and functional outcomes and also to provide a comprehensive comparison of MIPO and ORIF in the management of midshaft clavicle fractures. Methods: We conducted a systematic review to evaluate the complication incidence and clinical outcomes of MIPO for midshaft clavicle fractures. We searched PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, the Cochrane Database of Controlled Trials, and the Cochrane Database of Systematic Reviews databases without language or date restrictions. Studies focusing on midshaft clavicle fractures treated with MIPO were included, while other clavicle fractures and nonclinical studies were excluded. The risk of bias was assessed using the Methodological Index for Nonrandomized Studies criteria and the Risk of Bias Tool 2 Cochrane tool. Data synthesis included qualitative analysis, and if applicable, quantitative analysis and meta-analysis. Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines ensured reporting quality. Results: A total of 107 studies were initially identified, after applying inclusion and exclusion criteria, 22 studies were included for data extraction. These studies involved the evaluation of 714 clavicles treated with the MIPO technique. Of the 714 MIPO cases, 11 cases of implant failure, 5 nonunions, 2 infections, and 28 cases with neurological impairment were observed. Quantitative analysis comparing MIPO with ORIF revealed that MIPO had significantly shorter surgery time (mean difference −12.95, 95% confidence interval [−25.27 to −0.63], P = .04) and lower occurrence of numbness (odds ratio 0.29, 95% CI [0.15-0.56], P = .0002) compared to ORIF. Time to bone union, functional outcomes, and other complications were similar between MIPO and ORIF at the final follow-up. An overall moderate risk of bias was found across the studies. Conclusion: The MIPO technique yields good and comparable results to ORIF for midshaft clavicle fractures. Additionally, the MIPO technique may offer advantages such as reduced surgical time and lower chances of neurological impairment.http://www.sciencedirect.com/science/article/pii/S2666638323002657Minimally invasive plate osteosynthesisMIPOMidshaft clavicle fracturesSurgical treatmentClinical outcomesComparative analysis |
| spellingShingle | Vitor La Banca, MD Guilherme Henrique Vieira Lima, MD Ana Victoria Palagi Vigano, MD Felipe Fernandes Gonzalez, MD, MSc Henrique de Lazari Schaffhausser, MD Luiz Henrique Oliveira Almeida, MD Luis Gustavo Prata Nascimento, MD, MSc Joel Murachovsky, MD, PhD Roberto Yukio Ikemoto, MD, PhD Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis JSES International Minimally invasive plate osteosynthesis MIPO Midshaft clavicle fractures Surgical treatment Clinical outcomes Comparative analysis |
| title | Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis |
| title_full | Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis |
| title_fullStr | Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis |
| title_full_unstemmed | Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis |
| title_short | Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis |
| title_sort | complications and clinical outcomes with minimally invasive plate osteosynthesis mipo technique for midshaft clavicle fractures a systematic review and meta analysis |
| topic | Minimally invasive plate osteosynthesis MIPO Midshaft clavicle fractures Surgical treatment Clinical outcomes Comparative analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323002657 |
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