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Hand & Upper Limb
intermediate
X-Type

Clavicle Shaft Fractures - Indications for Surgery, Plate vs Intramedullary Fixation

Clavicle Fractures

A 28-year-old cyclist sustains a fall directly onto his left shoulder. He presents with pain, deformity, and tenting of the skin over the mid-clavicle. X-rays reveal a displaced, comminuted midshaft clavicle fracture with greater than 2 cm shortening and no neurovascular compromise. The orthopedic surgeon discusses treatment options, explaining that while historically most clavicle fractures were treated non-operatively with figure-of-8 bracing, recent evidence shows certain fractures (displaced, shortened greater than 2 cm, comminuted) have lower union rates and worse functional outcomes with non-operative treatment. The surgeon presents options of superior plating versus intramedullary fixation and their respective advantages and complications. Regarding clavicle shaft fractures:

Mark each as TRUE or FALSE

A

CLAVICLE FRACTURES account for 5-10% of all fractures; MIDSHAFT (middle third, 80%) most common, lat...

B

NON-OPERATIVE treatment: SIMPLE SLING most common (figure-of-8 brace uncomfortable, no better outcom...

C

Lateral third clavicle fractures are most common (midshaft rare); medial third is second most common...

D

OPERATIVE INDICATIONS (controversial but evolving): ABSOLUTE - open fracture, neurovascular compromi...

E

SURGICAL TECHNIQUES: SUPERIOR PLATING most common (precontoured anatomic plates, 3.5mm reconstructio...

Answer the questions to see explanations

Click T (True) or F (False) for each option