Executive Editor: Joseph Schatzker

Authors: Jonas Andermahr, Michael McKee, Diane Nam

Clavicle Lateral, displaced fracture with CC intact, fragmentary

back to skeleton

Glossary

Nonoperative treatment
Main indication Skill Equipment
Shortening or displacement < 2 cm. Low demand (typically elderly) patients Basic surgical experience, no specialized skills Basic equipment only


Supporting indications

  • Minimally displaced fractures
  • Low demand patients

Contraindications

  • Open fractures
  • Fractures with neurovascular compromise
  • Severe displacement
  • Active young patient
  • Combined injuries like floating shoulder
ORIF - Hook plate
Main indication Skill Equipment
Severely displaced fracture Highly experienced and skilled surgeon Full specialized surgical and imaging resources


Supporting indications

  • Small lateral fragment
  • Open fractures
  • Fractures with neurovascular compromise
  • Severe displacement
  • Active young patient

Contraindications

  • Poor soft tissue coverage
  • Active infection
  • Anticipated patient non-compliance (especially substance abuse)

Disadvantages

  • The hook of the plate often leads to alteration of the acromion and AC joint
  • Hardware is routinely removed
ORIF - Pre-contoured distal plate
Main indication Skill Equipment
Severely displaced fracture Highly experienced and skilled surgeon Full specialized surgical and imaging resources


Supporting indications

  • Lateral fragment of sufficient size for multiple screw fixation
  • Open fractures
  • Fractures with neurovascular compromise
  • Severe displacement
  • Active young patient

Contraindications

  • Poor soft tissue coverage
  • Active infection
  • Anticipated patient non-compliance (especially substance abuse)

Advantages

  • Generally no need for implant removal
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

2.0 2016-12-05