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Clavicle Fractures: To Operate or Not?

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Controversies in Orthopedic Surgery of The Upper Limb

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Abstract

Clavicle fractures are common injuries accounting for 2.6–4% of all fractures in adults. They have been traditionally treated conservatively; however, in the cases of displacement, surgical treatment has inarguably reduced the rate of nonunions. Plate fixation is the most common procedure used for the treatment of middle-third clavicle fractures, but intramedullary nails can be also used with similar functional and clinical results, as well as complication rate. Regarding fractures of the distal third of the clavicle, there are up-to-date no high-quality studies comparing surgical vs. conservative treatment, and until then it seems prudent to treat these injuries nonoperatively initially and reserve surgery for severely displaced fractures, high-demand patients, or failures of nonoperative care. In these cases, locking plate fixation seems a wiser approach especially if using pre-contoured implants and coracoclavicular ligament augmentation. Medial clavicle fractures account for 2–11% of all clavicle fractures and are usually associated with high-energy trauma. In displaced fractures, surgical treatment has been advised although no randomized controlled study has been published to date, being open reduction and plate fixation the choice in the published series.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, “La Paz” University Hospital-IdiPaz, Madrid, Spain

    Alonso Moreno-García & E. Carlos Rodríguez-Merchán

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  1. Alonso Moreno-García
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  1. Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

    E Carlos Rodríguez-Merchán

  2. Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

    Alonso Moreno-Garcìa

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Moreno-García, A., Rodríguez-Merchán, E.C. (2022). Clavicle Fractures: To Operate or Not?. In: Rodríguez-Merchán, E.C., Moreno-Garcìa, A. (eds) Controversies in Orthopedic Surgery of The Upper Limb . Springer, Cham. https://doi.org/10.1007/978-3-031-04907-1_6

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  • DOI: https://doi.org/10.1007/978-3-031-04907-1_6

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