Abstract
BACKGROUND: Minimally invasive plate osteosynthesis is a viable alternative to open reduction and internal fixation 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. This study hypothesized that dorsal decubitus (DD) positioning would result in lower surgical time (ST) and blood loss than BC positioning. METHODS: A retrospective cohort study included 30 patients treated for midshaft clavicle fractures with the minimally invasive plate osteosynthesis technique between 2020 and 2022. Patients were categorized into BC (n = 11) or DD (n = 19) positioning groups. Perioperative parameters, including positioning time (PT), ST, total surgical time, fluoroscopy time, surgical blood loss, delta hemoglobin, and delta hematocrit, 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 = .013). No significant differences were observed in ST, total surgical time, fluoroscopy time, 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 = .719). Changes in delta hemoglobin and delta hematocrit were also similar between groups (P = .261 and P = .810, respectively). DISCUSSION AND/OR CONCLUSION: This study found no significant differences in most perioperative parameters between BC and DD positioning, except for shorter PT in DD. Surgeons may select positioning based on practical considerations without compromising outcomes. Further research with larger cohorts is warranted.