A natural experiment study: Low-profile double plating versus single plating techniques in midshaft clavicle fractures—Study protocol

• Published in: PloS one Vol. 18; no. 9; p. e0291238
• Main Authors: Lecoultre, Yannic, van de Wall, Bryan J. M, Diwersi, Nadine, Pfarr, Steffen W, Galliker, Beat, Babst, Reto, Link, Björn-Christian, Beeres, Frank J. P
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 08.09.2023; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Bone healing; Care and treatment; Clavicle; Complications; Complications and side effects; Cost analysis; Emergency medical care; Engineering and Technology; Fractures; Geographical distribution; Geographical locations; Health services; Intervention; Medical research; Medicine and Health Sciences; Meta-analysis; Observational studies; Orthopedic surgery; Orthopedics; Osteosynthesis; Outpatient care facilities; Patient outcomes; Patient satisfaction; Patients; People and Places; Physical Sciences; Plating; Quality of life; Questionnaires; Research and Analysis Methods; Study Protocol; Surgeons; Surgery; Surgical outcomes; Sutures; Transplants & implants; Trauma; X-rays; Switzerland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291238

Single plate osteosynthesis is commonly employed when performing surgical stabilization of midshaft clavicle fractures. In recent years, a smaller structural low-profile double plating technique has been described as a possible solution for the high removal rates associated with single plating. A previous meta-analysis has demonstrated that low-profile double plating attains the same healing rates as single plating without a higher chance of fracture-related infections. This meta-analysis, however, was based on relatively small studies. Therefore, a multicentre prospective natural experiment was designed using natural variation in treatment regimens and geographical location of the trauma as treatment allocation mechanism to compare both treatments on a larger scale. This manuscript describes its protocol. This study will determine whether low-profile double plating has significant clinical and cost-effective benefits over single plating techniques in midshaft clavicle fractures. The study will also give insight in the performance of a natural experiment study design for orthopedic trauma research.