Summary
Evidence from one randomized controlled trial (RCT) suggests that patients that undergo
plate fixation for acute, displaced, clavicular midshaft fractures may score better
on patient-reported and physician-reported measures of shoulder function, may be less
likely to experience nonunion or complications requiring additional treatment and
may have shorter time to union than patients receiving nonoperative treatment. Plate
fixation patients tend to report higher satisfaction with shoulder appearance than
patients who don't have surgical repair. Higher loss to follow-up in the nonoperative
group, however, may influence the results. Data from case series of patients with
acute clavicular midshaft fractures support some, but not all of the conclusions from
the RCT. These inconsistencies may be partially explained by heterogeneity in the
populations, fracture characteristics, and study methods across studies. Additional
methodologically rigorous comparative studies are needed to confirm these findings.
