Extensive clinical studies reported in the literature have indicated that nonoperative treatment is the treatment of choice for midshaft clavicular fractures. However recent studies show that the incidence of nonunion is higher than once thought and surgical treatment should be considered in certain cases. The purpose of this study was to compare the outcome of conservative treatment and surgical treatment outcomes in patients with clavicular fractures. The charts of 200 patients admitted to the Trauma ward with clavicular fractures were reviewed from April 2002 through April 2006 at Legacy Emanuel Hospital. Ten of these patients had open reduction internal fixation of their fractures, the rest were treated non-operatively. Of those treated nonoperatively, three were noted to have nonunion whereas all of the surgical candidates had union. Of those treated surgically, one patient was noted to have hardware failure, no other complications were documented. The majority of both populations complained of pain, decreased range of motion and bony deformity during their follow-up appointments, however these findings improved with time. The retrospective nature of this study and small sample size limit the generalizability of the data. Given the advances in surgical techniques and types of fixation alternatives the authors suggest additional studies comparing surgical versus nonsurgical treatment of clavicular fractures be performed.
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