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Closed reduction and figure of 8 splinting
1%
25/2929
Open reduction and plate fixation
96%
2806/2929
Open reduction and percutaneous pinning
0%
5/2929
Simple sling to involved side
2%
70/2929
Sling with abduction pillow to involved side
7/2929
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The radiograph shows a comminuted clavicle fracture with significant displacement. Indications for surgical fixation of clavicle fractures include: open fractures, underlying neurovascular injury, or impending open fracture from internal bony pressure causing skin compromise. Relative indications for fixation include: greater than 15 mm of shortening, greater than 100% displacement (no bony contact), highly comminuted fractures, and polytrauma patients. Jeray et al review the evaluation and treatment of midshaft clavicle fractures. They state "when midshaft clavicular fractures are completely displaced or comminuted, and when they occur in elderly patients or females, the risk of nonunion, cosmetic deformity, and poor outcome may be markedly higher. Thus, some surgeons propose surgical stabilization of a complex midshaft clavicular fracture with either plate-and-screw fixation or intramedullary devices. Further randomized, prospective trials are needed to provide better data on which to base treatment decisions."
4.3
(30)
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