REVIEW ARTICLE


Nonoperative Treatment of Midshaft Clavicle Fractures in Adults



Sören Waldmann*, Emanuel Benninger, Christoph Meier
Clinic for Orthopaedics and Traumatology, Department of Surgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Basel, Switzerland


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© 2017 Waldmann et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Clinic for Orthopaedics and Traumatology, Department of Surgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401 Winterthur, Basel, Switzerland; Tel: +41522662121; E-mail: s.waldmann@me.com


Abstract

Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature. Most fractures are suitable for conservative treatment. There is solid evidence in favour of nonoperative treatment for fractures with a displacement of less than 2cm and remaining contact of the bone fragments. Clear indications for conservative treatment versus surgical fixation of displaced midshaft fractures have not finally been established yet, leaving some questions and problems unanswered. Furthermore, there are no evidence-based recommendations concerning the kind and duration of shoulder immobilisation with no clear advantage for any treatment modality.

Keywords: Clavicle fractures, Midshaft, Adult, Treatment, Conservative, Adults.