Work

Beach-chair and dorsal decubitus positioning in minimally invasive plate osteosynthesis for midshaft clavicle fractures: a comparative study

Year: 2025

Type: article

Abstract: Background Minimally invasive plate osteosynthesis (MIPO) is a viable alternative to open reduction and internal fixation (ORIF) for treating midshaft clavicle fractures, with advantages such as reduced complication rates and improved patient satisfaction. However, no consensus exists regarding the optimal surgical positioning—beach chair (BC) or horizontal dorsal decubitus (DD). This study hypothesized that DD positioning would result in lower surgical time and blood loss than BC positioning. Methods A retrospective cohort study included 30 patients treated for midshaft clavicle fractures with the MIPO technique between 2020 and 2022. Patients were categorized into BC (n=11) or DD (n=19) positioning groups. Perioperative parameters, including positioning time (PT), surgical time (ST), total surgical time (TT), fluoroscopy time (FT), surgical blood loss (BL), Delta Hemoglobin (ΔHb), and Delta Hematocrit (ΔHt), were analyzed. Comparisons were made using t-tests or Mann-Whitney U tests. Results PT was significantly shorter in the DD group (8.1 ± 5.1 minutes) compared to the BC group (12.5 ± 2.3 minutes; p=0.013). No significant differences were observed in ST, TT, FT, or BL between the groups. Mean blood loss was 79.0 ± 42.2 mL for BC and 73.2 ± 41.9 mL for DD (p=0.719). Changes in ΔHb and ΔHt were also similar between groups (p=0.261 and p=0.810, respectively). Discussion and/or Conclusion This study found no significant differences in most perioperative parameters between BC and DD positioning, except for shorter positioning time in DD. Surgeons may select positioning based on practical considerations without compromising outcomes. Further research with larger cohorts is warranted.

Source: JSES Reviews Reports and Techniques

DOI: 10.1016/j.xrrt.2025.06.001