The Journal of Bone and Joint Surgery, Vol 63, Issue 1 147-151, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Open reduction and internal fixation of clavicular fractures
EJ Zenni, JK Krieg and MJ Rosen
Extensive clinical studies reported in the literature have indicated that
non-operative treatment is the treatment of choice for clavicular
fractures. It has also been suggested by some that open reduction may
contribute to the development of non-union. From 1970 to 1978, twenty-five
of approximately 800 patients with a fracture of the clavicle were treated
by open reduction and internal fixation with a threaded intramedullary wire
or pin or with cerclage suture (one case). The patients' ages ranged from
thirteen to fifty-nine years. All fractures healed without infection or
migration of the pin. Based on this experience and a review of the
English-language literature, we concluded that the indications for open
reduction and internal fixation should be: (1) neurovascular compromise due
to posterior displacement and impingement of the bone fragments on the
brachial plexus, subclavian vessels, and even the common carotid artery;
(2) fracture of the distal third of the clavicle with disruption of the
coracoclavicular ligament; (3) severe angulation or comminution of a
fracture in the middle third of the clavicle; (4) the patient's inability
to tolerate prolonged immobilization (required by closed treatment) because
of Parkinson's disease, a seizure disorder, or other neuromuscular disease;
and (5) symptomatic non-union following treatment by closed methods.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
