• Jan W Duijff, Cornelis F M Sier, and Inger B Schipper.
• Leids Universitair Medisch Centrum, afd. Heelkunde, The Netherlands. j.w.duijff@lumc.nl
• Ned Tijdschr Geneeskd. 2010 Jan 1;154:A2367.

AbstractTraditionally, midshaft clavicular fractures have been treated conservatively. However a review of the literature reveals that certain fractures can benefit from operative repair. Conservative treatment, preferably in the form of a sling, of an undisplaced midshaft clavicular fracture leads to excellent results . Dislocated fractures have an increased risk of non-union or malunion. Intramedullary fixation can give good results in simple dislocated fractures, but does not provide optimal preservation of length and rotation in comminuted fractures. Plate osteosynthesis can be used for all clavicular fractures and causes a reduction of the relative risk of non-union of 86%. Due to the increased risk of non-union or malunion and of a worse functional result, osteosynthesis should be considered for patients with dislocated or comminuted midshaft clavicular fractures, with due consideration for the patient's expectations and lifestyle.

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