Midshaft clavicular fractures

Summary

Evidence from 3 small randomized controlled trials and 1 prospective cohort trial comparing operative treatment with nonoperative treatment of midshaft clavicular fractures tends to favor operative care. The proportion of patients achieving union is higher among those receiving operative treatment and the time to union shorter compared with nonoperative care. Functional outcomes scores are better for operatively treated patients compared with nonoperatively treated patients, and more operatively treated patients are satisfied with the cosmetic appearance of the affected shoulder and overall outcome. Complications after operative treatment included wound or pin track infections, incision site numbness, fracture site pain, or hardware issues, while complications after nonoperative treatment involved delayed union or malunion and fracture site pain. Further randomized studies may shed light on which of the several operative methods in use may be preferred.