Acute clavicular midshaft fractures

Summary

Evidence from one randomized controlled trial (RCT) suggests that patients that undergo plate fixation for acute, displaced, clavicular midshaft fractures may score better on patient-reported and physician-reported measures of shoulder function, may be less likely to experience nonunion or complications requiring additional treatment and may have shorter time to union than patients receiving nonoperative treatment. Plate fixation patients tend to report higher satisfaction with shoulder appearance than patients who don't have surgical repair. Higher loss to follow-up in the nonoperative group, however, may influence the results. Data from case series of patients with acute clavicular midshaft fractures support some, but not all of the conclusions from the RCT. These inconsistencies may be partially explained by heterogeneity in the populations, fracture characteristics, and study methods across studies. Additional methodologically rigorous comparative studies are needed to confirm these findings.