When is surgery indicated in the treatment of clavicle fractures?

Updated: Jan 14, 2019
  • Author: Benjamin P Kleinhenz, MD; Chief Editor: Craig C Young, MD  more...
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Answer

Surgical indications include the following:

  • Complete fracture displacement [4]

  • Severe displacement causing tenting of the skin with the risk of puncture

  • Fractures with 2 cm of shortening

  • Comminuted fractures with a displaced transverse "zed" (or Z-shaped) fragment [4]

  • Neurovascular compromise

  • Displaced medial clavicular fractures with mediastinal structures at risk [5]

  • Polytrauma (with multiple fractures): To expedite rehabilitation

  • Open fractures

  • An inability to tolerate closed treatment

  • Fractures with interposed muscle

  • Established, symptomatic nonunion

  • Concomitant glenoid neck fracture (floating shoulder)


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