LAURA N. SCIARONI MD

Fellow of the American Academy of Orthopedic Surgery
Member of the San Francisco Multispecialty Medical Group,
Part of the IPM Medical Group family
Board Certified, Fellowship Trained in Sports Medicine

Clavicle fracture – fix it or no?

As a cyclist, a clavicle fracture is an injury I think about personally.  Those of us out on the roads are more likely than most to end up at some point actually ON the road, or in the dirt.  The decision of whether to treat a clavicle fracture operatively or nonoperatively is an individual one.  Those that are not displaced are treated without surgery and generally go on to heal and those that are very displaced are more often treated with surgery.  There are some in-betweens where the decision is has to be more individualized based on the patient’s activities and tolerance for an uncosmetic bump versus surgical scar.

Surgical fixation of displaced fractures leads to a higher rate of healing, though the hardware used to fix these fractures is often prominent under the skin, and sometimes has to be removed later.  In this era of cost containment, the cost effectiveness of surgery versus nonoperative treatment must also be considered.  This article is a decision analysis that shows that not only do people who have their displaced fractures fixed surgically heal at higher rates and return to work faster, it is also overall more cost effective, even taking into account the need for hardware removal in some patients.

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