Group I - Middle 1/3 Clavicle Fracture
- 69%-85% of clavicle fractures.
- 0.13%-13% non-op nonunion rate overall
- Generally treated non-oeratively
- No difference between sling and figure-8 (Stanly, Injury 19;162:1988)
- Closed reduction not helpful (Hill, JBJS 79B;537:1997)
- 31% of non-op patients report shoulder weakness, fatigue, paresthesias and asymmetry.
- Shortening >18 mm in males or >14 mm in females is associated unsatisfactory result. (Lazarides S, JSES 2006;15:191)
- Operative indications=open fx, NVI, displaced fx with impending skin compromise, shortening >20mm, significant comminution, scapulothoracic dissociation. Consider for neurologic disorders, floating shoulder, bilateral fx, cosmesis, ipsiliateral UE fx.
- See Clavicle Fx ORIF Technique.