{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T10:13:50Z","timestamp":1793096030468,"version":"4.5.0"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Low-profile double plating seems a viable alternative to conventional single plating for fixation of midshaft clavicle fractures. This study aims to compare the two techniques regarding healing, complications, and removal rate.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective cohort study included all patients &gt;16 years that underwent plate fixation for midshaft clavicle fractures between 2020 and 2022 at one trauma-center. Exclusion criteria encompassed pathological or open fractures, refractures and delayed presentation or treatment more than 14 days after the accident. Patients were categorized into two treatment groups: Single plating (Synthes 3.5mm LCP superior \/ anterior or Synthes 2.7mm VA-LCP superior) and low-profile double plating (2.0 superior combined with either 2.4 or 2.7mm anterior mini-plate). Treatment groups were compared regarding healing, complications, and removal rate.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 99 patients were included: 74 in the single plating and 25 in the double plating group. Implant failures within the first three months were comparable in both groups (4.0% double plating versus 2.7% single, p = 0.744, of which one was caused by infection). Low-profile double plating had a significantly lower operation duration (95 versus 111 minutes, p = 0.019). Long-term follow-up data was available in 60 patients in the single plating and 20 in the double plating group. The need for reintervention was significantly lower in the double plating group (n = 5, 25.0% vs. n = 31, 51.7%, p = 0.038). These reinterventions were predominantly caused by implant irritation in both groups (n = 4, 20% double plating versus n = 29, 48.3% single plating, p = 0.026). All fractures healed in both groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Low-profile double plating attains comparable healing rates as single plating and has a significantly lower risk for re-intervention as well as a shorter operation duration. The lower reintervention rate is mainly explained by a lower incidence of implant irritation in the double plating group.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318004","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T18:52:13Z","timestamp":1737744733000},"page":"e0318004","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Low-profile double plating versus conventional single plating in midshaft clavicle fractures: A retrospective study and initial experience with this novel technique"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2291-8272","authenticated-orcid":true,"given":"Yannic","family":"Lecoultre","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"van de Wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern-Christian","family":"Link","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Kik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Babst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Beeres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"pone.0318004.ref001","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1067\/mse.2002.126613","article-title":"Epidemiology of clavicle fractures","volume":"11","author":"F Postacchini","year":"2002","journal-title":"Journal of shoulder and elbow surgery"},{"key":"pone.0318004.ref002","author":"S Hyland","year":"2024"},{"key":"pone.0318004.ref003","first-page":"663","article-title":"The clavicular fracture: a biomechanical study of the mechanism of clavicular fracture and modes of the fracture","volume":"83","author":"T Harnroongroj","year":"2000","journal-title":"J Med Assoc Thai"},{"key":"pone.0318004.ref004","doi-asserted-by":"crossref","first-page":"e468","DOI":"10.5435\/JAAOS-D-17-00442","article-title":"Management of Midshaft Clavicle Fractures in Adults.","volume":"26","author":"B Wiesel","year":"2018","journal-title":"The Journal of the American Academy of Orthopaedic Surgeons"},{"key":"pone.0318004.ref005","doi-asserted-by":"crossref","first-page":"22101","DOI":"10.1038\/s41598-021-01625-4","article-title":"No difference in mid-term outcome after superior vs. anteroinferior plate position for displaced midshaft clavicle fractures","volume":"11","author":"P-C Nolte","year":"2021","journal-title":"Scientific reports"},{"key":"pone.0318004.ref006","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jse.2015.09.005","article-title":"Anteroinferior versus superior plating of clavicular fractures","volume":"25","author":"MHJ Hulsmans","year":"2016","journal-title":"Journal of shoulder and elbow surgery"},{"key":"pone.0318004.ref007","article-title":"Does plate position influence the outcome in midshaft clavicular fractures? A multicenter analysis","author":"IR Buenter","year":"2024","journal-title":"Eur J Trauma Emerg Surg"},{"key":"pone.0318004.ref008","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1007\/s00068-021-01845-3","article-title":"Low profile dual plating for mid-shaft clavicle fractures: a meta-analysis and systematic review of observational studies.","volume":"48","author":"IF Rompen","year":"2022","journal-title":"European journal of trauma and emergency surgery: official publication of the European Trauma Society"},{"key":"pone.0318004.ref009","first-page":"265","article-title":"Clinical Outcomes of Double Mini\u2011Plating Compared with a Single Superior Plating in Midshaft Clavicular Fractures: A Randomized Clinical Trial Study.","volume":"12","author":"MJ Kafiabadi","year":"2023","journal-title":"Advanced Biomedical Research"},{"key":"pone.0318004.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clinbiomech.2022.105634","article-title":"Low-profile dual mini-fragment plating of diaphyseal clavicle fractures. A biomechanical comparative testing.","volume":"94","author":"T Pastor","year":"2022","journal-title":"Clinical Biomechanics"},{"key":"pone.0318004.ref011","doi-asserted-by":"crossref","first-page":"e0291238","DOI":"10.1371\/journal.pone.0291238","article-title":"A natural experiment study: Low-profile double plating versus single plating techniques in midshaft clavicle fractures\u2014Study protocol","volume":"18","author":"Y Lecoultre","year":"2023","journal-title":"PLOS ONE"},{"key":"pone.0318004.ref012","article-title":"Clavicle nonunion and plate breakage after locking compression plate fixation of displaced midshaft clavicular fractures","author":"X Huang","year":"2019","journal-title":"Exp Ther Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T18:52:18Z","timestamp":1737744738000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318004"}},"subtitle":[],"editor":[{"given":"Hans-Peter","family":"Simmen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318004","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}