{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:41:33Z","timestamp":1792320093403,"version":"4.4.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Medical Science Research Project of Hebei","award":["20220292"],"award-info":[{"award-number":["20220292"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare mini-open intramedullary fixation and plate fixation for Robinson type II midshaft clavicle fractures, with supraclavicular nerve preservation attempted in both approaches, regarding postoperative numbness, pain, shoulder function, perioperative outcomes, and fracture healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 75 adults with Robinson type II midshaft clavicle fractures treated between September 2019 and January 2025. Group A (n=35) underwent mini-open intramedullary fixation with a 2.0\u20132.5-mm titanium Kirschner wire, and Group B (n=40) underwent plate fixation; supraclavicular nerve preservation was attempted in both groups. Incision length, blood loss, operation time, postoperative numbness, visual analogue scale pain scores, Constant-Murley scores, nonunion, and implant-related events were assessed, using generalized estimating equations and linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline characteristics were comparable. Group A had a shorter incision (mean difference, \u22128.99 cm), less blood loss (\u221238.42 mL), and a shorter operation time (\u221224.96 min; all P&lt;0.001). Numbness rates were lower in Group A at 2 weeks, 3 months, and 6 months; at 12 months, 5.7% versus 22.5% (P=0.053). Group B had higher overall odds of postoperative numbness (OR=3.98, 95% CI 1.58\u20139.98; P=0.003). Pain scores decreased in both groups (group-by-time interaction, P&lt;0.001), with no significant between-group difference at 12 months (P=0.163). Constant-Murley scores were lower in Group A at 3 months (89.4\u00b14.4 vs 93.0\u00b14.9; P=0.001) but similar at 6 and 12 months; the group-by-time interaction was significant (P=0.003). Nonunion rates were similar. Implant irritation occurred in 2\/35 Group A patients (5.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mini-open intramedullary fixation with attempted supraclavicular nerve preservation was associated with less surgical trauma, lower early postoperative pain, and lower overall odds of numbness than plate fixation. The 3-month Constant-Murley advantage of plating was not sustained at 6 or 12 months, and fracture healing was comparable. Implant irritation occurred in 5.7% of Group A patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261492755","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:32:20Z","timestamp":1792060340000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mini-open intramedullary fixation with attempted supraclavicular nerve preservation versus plate fixation for midshaft clavicle fractures: A retrospective comparative study"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0641-965X","authenticated-orcid":false,"given":"Kesai","family":"Yang","sequence":"first","affiliation":[{"name":"Army Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxing","family":"Sun","sequence":"additional","affiliation":[{"name":"Baoding First Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongtao","family":"Li","sequence":"additional","affiliation":[{"name":"Army Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6261-5006","authenticated-orcid":false,"given":"Changqing","family":"Hu","sequence":"additional","affiliation":[{"name":"Baoding First Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_6_2_2","first-page":"CD009363","article-title":"Surgical versus conservative interventions for treating fractures of the middle third of the clavicle","volume":"1","author":"Lenza M","year":"2019","unstructured":"Lenza M, Buchbinder R, Johnston RV, et al. Surgical versus conservative interventions for treating fractures of the middle third of the clavicle. Cochrane Database Syst Rev 2019; 1: CD009363. https:\/\/doi.org\/10.1002\/14651858.CD009363.pub3","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_6_3_2","first-page":"711","article-title":"Midclavicular fracture: not just a trivial injury: current treatment options","volume":"107","author":"Schiffer G","year":"2010","unstructured":"Schiffer G, Faymonville C, Skouras E, et al. Midclavicular fracture: not just a trivial injury: current treatment options. Dtsch Arztebl Int 2010; 107: 711\u2013717. https:\/\/doi.org\/10.3238\/arztebl.2010.0711","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-020-01424-4"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-021-05113-2"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.05.069"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2022.02.026"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-025-02854-2"},{"issue":"25","key":"e_1_3_6_9_2","first-page":"1897","article-title":"Comparison of therapeutic effects between traditional open and minimally invasive plate osteosynthesis with locking compression plate for midclavicular fractures","volume":"103","author":"Zheng ST","year":"2023","unstructured":"Zheng ST, Hu X, Zhao EZ. Comparison of therapeutic effects between traditional open and minimally invasive plate osteosynthesis with locking compression plate for midclavicular fractures. Natl Med J China 2023; 103(25): 1897\u20131902.","journal-title":"Natl Med J China"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-025-00865-8"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04220-7"},{"issue":"4","key":"e_1_3_6_12_2","first-page":"351","article-title":"Application of supraclavicular nerve protection in clavicle fracture fixation","volume":"22","author":"Pan XB","year":"2020","unstructured":"Pan XB, Wei KH, Guan LZ, et al. Application of supraclavicular nerve protection in clavicle fracture fixation. Chin J Orthop Trauma 2020; 22(4): 351\u2013355.","journal-title":"Chin J Orthop Trauma"},{"issue":"5","key":"e_1_3_6_13_2","first-page":"347","article-title":"Clinical effect observation of supraclavicular nerve protection during open reduction and internal fixation of clavicle fractures","volume":"36","author":"Yang KS","year":"2020","unstructured":"Yang KS, He YF, Hu CQ. Clinical effect observation of supraclavicular nerve protection during open reduction and internal fixation of clavicle fractures. Chin J Hand Surg 2020; 36(5): 347\u2013349.","journal-title":"Chin J Hand Surg"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.80B3.0800476"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.03.021"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000906"},{"issue":"9","key":"e_1_3_6_17_2","first-page":"563","article-title":"Research progress in early diagnosis of limb nonunion","volume":"38","author":"Yang R","year":"2018","unstructured":"Yang R, Chen YX. Research progress in early diagnosis of limb nonunion. Chin J Orthop 2018; 38(9): 563\u2013569.","journal-title":"Chin J Orthop"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00289-8"},{"key":"e_1_3_6_19_2","volume-title":"Treatment of Clavicle Fractures: Evidence-Based Clinical Practice Guideline","author":"American Academy of Orthopaedic Surgeons","year":"2022","unstructured":"American Academy of Orthopaedic Surgeons. Treatment of Clavicle Fractures: Evidence-Based Clinical Practice Guideline. American Academy of Orthopaedic Surgeons, 2022. Published December 2, 2022."},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2016.01.018"},{"key":"e_1_3_6_21_2","first-page":"e93135","article-title":"Plate fixation versus intramedullary nailing for displaced clavicular shaft fractures: an updated meta-analysis of randomized controlled trials","volume":"17","author":"Oar DP","year":"2025","unstructured":"Oar DP, DeFrancisis JS, Abouafech A, et al. Plate fixation versus intramedullary nailing for displaced clavicular shaft fractures: an updated meta-analysis of randomized controlled trials. Cureus 2025; 17: e93135. https:\/\/doi.org\/10.7759\/cureus.93135","journal-title":"Cureus"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1194050"},{"key":"e_1_3_6_23_2","first-page":"230","article-title":"New interlocking intramedullary nail for treating acute midshaft clavicular fractures in adults: a retrospective study","volume":"29","author":"Kibar B","year":"2023","unstructured":"Kibar B, Cavit A, Ors A, et al. New interlocking intramedullary nail for treating acute midshaft clavicular fractures in adults: a retrospective study. Ulus Travma Acil Cerrahi Derg 2023; 29: 230\u2013235. https:\/\/doi.org\/10.14744\/tjtes.2022.50517","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-023-04874-2"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2021-103197"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.898664"},{"issue":"5","key":"e_1_3_6_27_2","first-page":"454","article-title":"Anatomical observation of supraclavicular nerve distribution in supraclavicular region","volume":"24","author":"He YF","year":"2019","unstructured":"He YF, Hu CQ, Lian Y, et al. Anatomical observation of supraclavicular nerve distribution in supraclavicular region. Chin J Anat Clin 2019; 24(5): 454\u2013457.","journal-title":"Chin J Anat Clin"},{"issue":"5","key":"e_1_3_6_28_2","first-page":"449","article-title":"Effect of intraoperative supraclavicular nerve protection on clavicle fracture healing rate","volume":"26","author":"Sun JX","year":"2024","unstructured":"Sun JX, Hu CQ, Zhu L, et al. Effect of intraoperative supraclavicular nerve protection on clavicle fracture healing rate. Chin J Orthop Trauma 2024; 26(5): 449\u2013454.","journal-title":"Chin J Orthop Trauma"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-04777-z"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.335823"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-017-0848-9"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-020-00223-2"},{"key":"e_1_3_6_33_2","first-page":"379","article-title":"Clinical outcomes of midclavicular fractures treated with titanium elastic nails","volume":"53","author":"Chen YF","year":"2010","unstructured":"Chen YF, Zeng BF, Chen YJ, et al. Clinical outcomes of midclavicular fractures treated with titanium elastic nails. Can J Surg 2010; 53: 379\u2013384.","journal-title":"Can J Surg"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126131"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(17)30735-0"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2020.1793668"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261492755","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536261492755","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261492755","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:17:19Z","timestamp":1792318639000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536261492755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/10225536261492755"],"URL":"https:\/\/doi.org\/10.1177\/10225536261492755","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"article-number":"10225536261492755"}}