Titanium Nailing versus Plate Fixation for Management of Clavicular Fractures in Adult Indian Patients: A Systematic Review and Meta-Analysis

Clavicular fractures are common orthopedic injuries in adults, with displaced fractures increasingly managed surgically to improve union and functional outcomes. Titanium elastic intramedullary nailing and plate fixation are the two most commonly employed operative techniques. Although both techniques are widely practiced in India, uncertainty persists regarding their comparative effectiveness, safety, cosmetic outcomes, and complication profiles. Existing systematic reviews have limitations, including inadequate capture of Indian randomized controlled trials, mixing of pediatric and adult populations, and overrepresentation of high-income country data. This review aims to address these gaps through a focused synthesis of randomized evidence from the Indian adult population.