A study published in the July 19 issue of The Journal of Bone & Joint Surgery compares surgical and nonsurgical treatment approaches for displaced midshaft clavicle fracture. The authors conducted a prospective, randomized, controlled trial of 117 patients who received either nonsurgical treatment with a figure-of-eight harness or surgical treatment with anteroinferior plate osteosynthesis. 

At 6-week, 6-month, and 1-year follow-ups, they found no difference across cohorts in Disabilities of the Arm, Shoulder and Hand score, visual analog scale pain level, time to return to previous activities, or cosmetic dissatisfaction. However, the authors note that seven nonsurgical patients (14.9 percent) developed nonunion, compared to none in the surgical group. Further, nonsurgically treated patients displayed radiographic evidence of greater clavicle shortening compared with those in the surgical cohort, and more patients in that group answered "yes" when asked if their clavicle felt short and if they felt bone prominence. In the surgical group, more patients answered "yes" when asked if they felt paresthesia. Learn more...