title: Shaft fractures of the clavicle: current concepts.
abstract: Fractures of the clavicle are common and have been typically addressed to nonoperative treatment. Favorable results, which predominantly were achieved in the young and adolescents, were supposed to be usual in midshaft clavicular fractures. However, in the presence of comminution or complete displacement, especially when occurring in females or elderly patients, there is a marked risk of nonunion, malunion, and poor outcome. Thus, many authors prefer primary surgical stabilization, when risk factors add up. Plate fixation and intramedullary stabilization seem to be equally favored. Though, indications for operative management remain controversial. Further prospective randomized comparative clinical trials are necessary for a well-founded risk-benefit analysis.
authors.affiliation: Department of Trauma Surgery and Sports Medicine, Innsbruck Medical University, Innsbruck, Austria. Vinzenz.Smekal@uki.at
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Smekal
authors.forename: Juergen
authors.initials: J
authors.lastname: Oberladstaetter
authors.forename: Peter
authors.initials: P
authors.lastname: Struve
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krappinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005596:Fractures, Closed / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D055815:Young Adult