REVIEWSmall-Incision, Intramedullary Compression Osteosynthesis of Acute and Non-United Midshaft Clavicle FracturesParsons, Moby MD; Blitzer, Charles M MDAuthor Information Seacoast Orthopedics and Sports Medicine, Somersworth, NH Reprints: I. M. Parsons, IV, MD, Seacoast Orthopedics and Sports Medicine, 237 Route 108, Suite 205, Somersworth, NH 03878 (e-mail: [email protected]). Techniques in Shoulder and Elbow Surgery: December 2005 - Volume 6 - Issue 4 - p 218-225 doi: 10.1097/01.bte.0000187285.99726.0e Buy Metrics Abstract Intramedullary screw fixation of midshaft clavicle fractures represents an excellent alternative to plate and screw fixation for both acute fractures and nonunions, and can be performed through a small, cosmetically-pleasing incision. We recommend operative treatment for fractures with severe displacement including >2 cm of shortening or lack of cortical apposition. Fractures in high performance athletes who require an accelerated recovery for return of function represents another indication for open reduction internal fixation (ORIF). This procedure is less invasive and reduces tissue trauma and periosteal stripping when compared to plate fixation. It is also biomechanically comparable to plate fixation in terms of bending rigidity and equally as effective in achieving fracture union. Because of these and other advantages as well as the relative ease and reproducibility of this technique, we are employing this method of fixation with increasing frequency. © 2005 Lippincott Williams & Wilkins, Inc.