Outcomes of Clavicle Injuries

Abstract

Clavicle fractures are common and most often occur at the middle-third of the clavicle across all age groups. Nonoperative treatment for clavicle fractures has long been the standard of care and remains the standard for nondisplaced or minimally displaced fractures. Nonunion and symptomatic malunion are more common than previously reported and have led to decreased patient outcome scores in displaced fractures. Recent evidence supports the use of surgical fixation for displaced or shortened clavicle fractures in active individuals and has been shown to optimize these patient’s outcomes by reducing pain from nonunion, malunion, or shoulder dysfunction. Neer type II displaced distal-third clavicle fractures are prone to nonunion with conservative care and may lead to continued discomfort or cosmetic deformity. Surgical fixation for these distal fractures has reduced the nonunion rate but complications are frequent. Studies reporting on the outcomes after surgical fixation of distal clavicle fractures have shown conflicting clinical benefits and careful patient selection is therefore critical. Medial-third clavicle fractures are rare and are more commonly nondisplaced or minimally displaced, requiring conservative measures alone. Discussion and patient education prior to treatment is essential to achieve optimal outcomes and mitigate complications in clavicle fracture management.