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Shakya et al. Journal of Orthopaedics and Traumatology (2025) 26:51 https://doi.org/10.1186/s10195-025-00865-8ORIGINAL ARTICLEOpen Access© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by- nc- nd/4. 0/.Journal of Orthopaedicsand TraumatologyMinimally invasive plate osteosynthesis (MIPO) with mini-open technique versus open reduction and internal fi xation (ORIF) in the treatment of displaced midclavicular fracture: a retrospective studySujan Shakya 1 , Yi Wen 1 , Xiang Wen 1 and Cheng Long 1* Abstract Introduction Minimally invasive plate osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fi xation (ORIF) for the treatment of dif f erent long bone fractures. This retrospective study aimed to com-pare MIPO with the mini-open technique versus conventional ORIF for the treatment of displaced midshaft clavicular fractures. We hypothesized that this technique would improve supraclavicular nerve (SCN) injury-related numbness, decrease surgical incision, blood loss, thick scar, and overall patient satisfaction.Methods We retrospectively reviewed 45 cases of displaced midclavicular fractures that were treated surgically at our hospital between December 2020 and June 2022. There were 20 (44.4%) patients using mini-open with MIPO and 25 (55.6%) patients using conventional ORIF treated with anatomical locking plate guided by C-arm X-ray machine. Comparison of surgical indices (operative time, blood loss, incision length, and fl uoroscopy exposure times) and post-operative complications (anterior chest wall numbness, area of numbness, superf i cial infection, hardware irritation, and scar satisfaction) were compared between the two groups. In addition, Disabilities of the Arm, Shoulder and Hand (DASH), Constant–Murley Score (CMS), and overall surgical satisfaction were compared between the two groups.Results The mini-open MIPO group had statistically signif i cant benef i ts on the basis of surgical length, blood loss, vis-ual analog scale (VAS) score on the fi rst and third postoperative days, and length of hospital stay. Major complications, such as SCN-related numbness, area of numbness, and thick scarring, were greatly reduced. The cosmetic and over-all surgical satisfaction was greater in MIPO. Conversely, hardware irritation, surgical infection, and numbness were more frequent in the ORIF group. There were no signif i cant dif f erences in DASH and CMS scores between the groups at the 12-month follow-up.Conclusions MIPO is a more ef f ective and safer modern surgical method than ORIF for displaced midclavicle frac-tures. Improvements in operative indices, postoperative numbness owing to SCN injury, surgical incision, and cosme-sis satisfaction were achieved.Level of evidence Level III, retrospective case–control study.Keywords MIPO, ORIF, Midclavicular Fracture, Supraclavicular nerve, DASH, CMS*Correspondence:Cheng Longhxlongcheng@163.com