| Nonoperative treatment | ||
| Main indication | Skill | Equipment |
|---|---|---|
| Shortening or displacement < 2 cm. Low demand (typically elderly) patients |  |
 |
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 |  |
 |
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 | |
|
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 |
 |
Some specialized surgical experience |
|
Highly experienced and skilled surgeon |
| *Equipment | |
|---|---|
|
Basic equipment only |
 |
Simple surgical and imaging resources |
|
Full specialized surgical and imaging resources |