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Management of Midshaft Clavicle Fractures in Adults

Wiesel, Brent, MD; Nagda, Sameer, MD; Mehta, Samir, MD; Churchill, Ryan, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 15, 2018 - Volume 26 - Issue 22 - p e468–e476
doi: 10.5435/JAAOS-D-17-00442
Review Article

Fractures of the clavicle are common injuries that occur across all age groups but are most frequently seen in the young, active patient population. Among the different types of clavicle fractures, those occurring in the middle third of the clavicular shaft are the most common. Historically, most of these fractures were treated by closed means even when notable displacement was present. Recently, there has been a renewed interest in assessing the best treatment option for these patients. Although nonsurgical treatment is a reliable method for treating many of these fractures, more recent data suggest that fractures with notable displacement (>2 cm of shortening or >100% displacement) and/or comminution have better short-term outcomes and lower rates of nonunion with surgical management. Current surgical options include superior plating, anterior-inferior plating, dual plating, and intramedullary nail fixation.

From the MedStar Georgetown University Hospital, Washington, DC (Dr. Wiesel and Dr. Churchill), the Anderson Orthopaedic Clinic, Alexandria, VA (Dr. Nagda), and the Hospital of the University of Pennsylvania, Philadelphia, PA (Dr. Mehta).

Dr. Mehta or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Zimmer Biomet, Smith & Nephew, and AO North America; serves as a paid consultant to Smith & Nephew and DePuy Synthes; has received research or institutional support from Amgen, Medtronic, and Smith & Nephew; and serves as a board member, owner, officer, or committee member of the Pennsylvania Orthopaedic Society. None of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wiesel, Dr. Nagda, and Dr. Churchill.

© 2018 by American Academy of Orthopaedic Surgeons
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