Immediate weight bearing after dual orthogonal plate fixation of clavicle fractures: a propensity-matched retrospective cohort study
- 1Department of Orthopaedic Surgery, University of Missouri, Columbia, USA
- 2School of Medicine, University of Missouri, Columbia, USA
- 3Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
Abstract
Purpose: To evaluate whether immediate weight bearing as tolerated (WBAT) following open reduction and internal fixation of clavicle fractures with a dual mini-fragmentation plate construct increases complications, implant failure, or worsens functional and patient-reported outcomes compared to a restricted weight-bearing protocol.
Methods: Adult patients (≥ 18 years) who underwent open reduction and internal fixation of a clavicle fracture were retrospectively identified and stratified into restricted weight-bearing or weight bearing as tolerated (WBAT) cohorts. Cohorts were matched for demographic and injury characteristics. All WBAT fractures were treated with dual orthogonal mini-fragmentation plate fixation, whereas restricted weight-bearing fractures were treated with either single- or dual-plate fixation. Outcomes included complications (infection, wound dehiscence, hardware prominence, implant failure, and loss of reduction) and PROMIS Physical Function and Pain Interference scores.
Results: Among 378 initial patients, 93 were included after propensity score matching: 62 in the restricted weight-bearing group and 31 in the WBAT group. Complication rates were similarly infrequent between groups (all p ≥ 0.326), with no fixation failures or deep surgical site infections occurring in the WBAT group.
Conclusions: Early weight bearing as tolerated may be safe following dual mini-fragmentation plate fixation of clavicle fractures, with comparable complication rates, union rates, and patient-reported outcomes to restricted weight-bearing protocols. These findings support the use of early mobilization in patients with rigid internal fixation constructs and may facilitate improved functional recovery and earlier return to activity.
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BibTeX
@article{monhollen2026immediate,
title = {{Immediate weight bearing after dual orthogonal plate fixation of clavicle fractures: a propensity-matched retrospective cohort study}},
author = {Andrew Monhollen and Lena Kolostov and Nash Kolb and Rown Parola and Anna Jacques and Wayne Hoskins and Douglas Haase},
journal = {European Journal of Orthopaedic Surgery \& Traumatology},
year = {2026},
month = oct,
doi = {10.1007/s00590-026-04959-9},
url = {https://doi.org/10.1007/s00590-026-04959-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Immediate weight bearing after dual orthogonal plate fixation of clavicle fractures: a propensity-matched retrospective cohort study
AU - Andrew Monhollen
AU - Lena Kolostov
AU - Nash Kolb
AU - Rown Parola
AU - Anna Jacques
AU - Wayne Hoskins
AU - Douglas Haase
PY - 2026
DA - 2026/10/25
JO - European Journal of Orthopaedic Surgery & Traumatology
DO - 10.1007/s00590-026-04959-9
UR - https://doi.org/10.1007/s00590-026-04959-9
AB - Purpose: To evaluate whether immediate weight bearing as tolerated (WBAT) following open reduction and internal fixation of clavicle fractures with a dual mini-fragmentation plate construct increases complications, implant failure, or worsens functional and patient-reported outcomes compared to a restricted weight-bearing protocol. Methods: Adult patients (≥ 18 years) who underwent open reduction and internal fixation of a clavicle fracture were retrospectively identified and stratified into restricted weight-bearing or weight bearing as tolerated (WBAT) cohorts. Cohorts were matched for demographic and injury characteristics. All WBAT fractures were treated with dual orthogonal mini-fragmentation plate fixation, whereas restricted weight-bearing fractures were treated with either single- or dual-plate fixation. Outcomes included complications (infection, wound dehiscence, hardware prominence, implant failure, and loss of reduction) and PROMIS Physical Function and Pain Interference scores. Results: Among 378 initial patients, 93 were included after propensity score matching: 62 in the restricted weight-bearing group and 31 in the WBAT group. Complication rates were similarly infrequent between groups (all p ≥ 0.326), with no fixation failures or deep surgical site infections occurring in the WBAT group. Conclusions: Early weight bearing as tolerated may be safe following dual mini-fragmentation plate fixation of clavicle fractures, with comparable complication rates, union rates, and patient-reported outcomes to restricted weight-bearing protocols. These findings support the use of early mobilization in patients with rigid internal fixation constructs and may facilitate improved functional recovery and earlier return to activity.
SN - 1633-8065
SN - 1432-1068
ER -