Will My Clavicle Heal?

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The management of clavicular fractures has changed substantially in the last fifteen years. In 1997, Hill et al. documented poor results and increased risk of nonunion in clavicular fractures with initial shortening of ≥20 mm1. McKee et al. confirmed this finding in a study involving more sophisticated outcome assessments including Constant and DASH (Disabilities of the Arm, Shoulder and Hand) scores as well as muscle strength testing2. However, the 2007 publication of the results of a randomized clinical trial conducted by the Canadian Orthopaedic Trauma Society3 showing improved outcomes with surgical management of displaced clavicular fractures appears to represent the “pivot point,” following which clinical practice began to be more commonly surgical. Despite the accumulating evidence of the potential for compromised functional outcome …