Re-evaluating clavipectoral fascial plane block in light of the midclavicle block: clinical evidence and anatomical rationale

We read with great interest the recent cadaveric study by Labandeyra et al, proposing the Midclavicle Block (MCB) as a novel approach to achieve comprehensive periosteal coverage in midshaft clavicle fractures.1 Their structured three-point injection technique, comprising two anterosuperior and one posteroinferior periosteal deposits administered via the subclavius muscle, representsa commendable advancement in addressing anatomical limitations observed with the conventional clavipectoral fascial plane block (CFPB). The authors convincingly demonstrated that MCB resulted in balanced methylene blue staining of both anterosuperior (55.5%) and posteroinferior (53.8%) clavicular surfaces, even in fractured specimens, while notably sparing critical neurovascular structures such as the brachial plexus and phrenic nerve.