{
  "schemaVersion": 2,
  "eyebrow": "Orthopaedic Trauma",
  "title": "Clavicle Fracture",
  "summary": "Management hinges on fracture location, displacement, stability, soft-tissue status, and associated neurovascular injury. Most minimally displaced fractures can be treated nonoperatively, whereas open injury, neurovascular compromise, unstable distal patterns, and selected completely displaced midshaft fractures warrant early fixation discussions.",
  "seoDescription": "Point-of-care approach to clavicle fracture evaluation and treatment, including operative indications and evidence for displaced midshaft fractures.",
  "clinicalQuestion": "How should clinicians select nonoperative versus operative management for an acute clavicle fracture?",
  "specialty": "Orthopaedic Surgery",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "clavicle fracture",
    "midshaft clavicle fracture",
    "distal clavicle fracture",
    "clavicle ORIF",
    "nonoperative clavicle management"
  ],
  "keyTakeaways": [
    "Open fracture and neurovascular injury requiring exploration or repair are absolute indications for fixation. [22]",
    "For completely displaced midshaft fractures in active adults, plate fixation improves 1-year functional outcome and lowers malunion and nonunion compared with sling treatment. [10]",
    "In randomized-trial meta-analysis, plate fixation reduced nonunion and malunion versus nonsurgical treatment but increased overall complications; functional DASH outcomes were not significantly different. [11]",
    "Lateral-third fracture decisions depend principally on stability, displacement, and patient age; most nondisplaced or minimally displaced extra-articular fractures are treated nonoperatively. [6]"
  ],
  "sections": [
    {
      "id": "triage-and-fracture-definition",
      "eyebrow": "Initial Decisions",
      "heading": "Identify injuries that require urgent operative assessment",
      "intro": "Classify location and immediately separate uncomplicated closed injuries from threats to skin, vessels, or nerves.",
      "paragraphs": [
        "Document whether the fracture is medial, midshaft, or lateral third; the Allman framework identifies middle-third fractures as the commonest group, lateral-third fractures as distal to the coracoclavicular ligaments and more prone to nonunion, and medial-end fractures as a distinct subgroup. [7]",
        "Urgently involve orthopaedic surgery for an open clavicle fracture or associated neurovascular injury requiring exploration or repair, both cited as absolute indications for fixation. [22] In polytrauma, bilateral fractures, brachial plexus injury, closed head injury, and selected unstable distal patterns, the treatment threshold may shift toward fixation. [7]",
        "For displaced or complex injuries being considered for definitive intervention, obtain CT or MRI when needed to define fracture extent and plan management. [1] CT-based three-dimensional characterization has been used to assess complex intra-articular fracture anatomy, although its principal role is preoperative planning rather than routine evaluation of simple fractures. [4]"
      ],
      "bullets": [
        "Record skin status and any threatened or open wound; open injury is an operative indication. [22]",
        "Perform and document brachial plexus and distal vascular examination; an injury requiring exploration or repair is an operative indication. [22]",
        "Identify polytrauma, bilateral fracture, and associated head injury because these circumstances may favor fixation despite a closed fracture. [7]"
      ],
      "subsections": [],
      "table": {
        "caption": "Initial branch points that change clavicle fracture disposition and treatment planning. [7][22]",
        "columns": [
          "Finding",
          "Interpretation",
          "Next action"
        ],
        "rows": [
          [
            "Open fracture",
            "Absolute indication for fixation. [22]",
            "Urgent orthopaedic operative assessment. [22]"
          ],
          [
            "Neurovascular injury requiring exploration or repair",
            "Absolute indication for fixation. [22]",
            "Urgent operative assessment and repair planning. [22]"
          ],
          [
            "Completely displaced midshaft fracture in an active adult",
            "Higher nonunion and malunion risk with nonoperative care; primary plate fixation improves 1-year outcomes in randomized evidence. [10]",
            "Discuss sling treatment versus primary fixation using healing, complication, activity, and cosmetic priorities. [10][11]"
          ],
          [
            "Nondisplaced or minimally displaced extra-articular lateral-third fracture",
            "Usually suitable for nonoperative treatment. [6]",
            "Use nonoperative immobilization and follow-up. [6]"
          ]
        ]
      }
    },
    {
      "id": "location-based-treatment-selection",
      "eyebrow": "Treatment Selection",
      "heading": "Use location and stability to select initial management",
      "intro": "The key treatment distinction is stable minimally displaced injury versus unstable or completely displaced injury.",
      "paragraphs": [
        "For lateral-third fractures, treat most nondisplaced or minimally displaced extra-articular injuries nonoperatively using the same general rehabilitation and immobilization approaches used for nonoperative midshaft and medial-end injuries. [6] Escalate toward surgery when the lateral segment pattern is unstable or displaced; patient age also enters that decision. [6]",
        "For midshaft fractures, displacement and shortening inform the operative discussion. One current-concepts review includes shortening greater than 2 cm, displaced fracture, bilateral injury, brachial plexus injury, closed head injury, polytrauma, and unstable distal type II patterns among situations supporting operative treatment. [7] Moderately displaced middle-third fractures can still have satisfactory nonoperative outcomes. [9]",
        "Use a sling as the studied nonoperative comparator for displaced midshaft fracture trials. [10][11] Bandage-based conservative options also include simple sling, Velpeau bandage, and other arm-supporting bandages. [24] Do not equate radiographic displacement alone with a universal mandate for fixation; the evidence-based tradeoff differs between completely displaced, active-adult injuries and more moderate displacement. [9][10][11]"
      ],
      "bullets": [
        "Stable lateral-third fracture: favor nonoperative care. [6]",
        "Unstable or displaced lateral-third fracture: assess for fixation based on fragment stability, displacement, and age. [6]",
        "Completely displaced midshaft fracture in an active adult: offer primary plate fixation as an evidence-supported option. [10]",
        "Moderately displaced midshaft fracture: nonoperative treatment remains reasonable when patient-specific risk tolerance favors avoidance of surgical complications. [9][11]"
      ],
      "subsections": [
        {
          "heading": "Shared decision-making for displaced midshaft fracture",
          "paragraphs": [
            "Explain that nonoperative treatment of displaced midshaft fractures has been associated with nonunion rates up to 15.1% in reported clinical series and meta-analytic data, while a meta-analysis cited in the randomized trial found nonunion of 2.2% after primary plate fixation versus 15.1% after nonoperative care. [8][10] This benefit is most directly applicable to completely displaced midshaft fractures rather than all clavicle fractures. [10]",
            "Balance improved union, lower malunion, and improved appearance-related outcomes after open reduction and plate fixation against a higher overall complication rate. In an RCT meta-analysis, ORPF reduced nonunion (RR 0.11, 95% CI 0.06-0.23), malunion (RR 0.16, 95% CI 0.08-0.35), appearance dissatisfaction (RR 0.35, 95% CI 0.23-0.55), and shoulder appearance defect (RR 0.06, 95% CI 0.02-0.17), but complications were more frequent with surgery (RR 1.60, 95% CI 1.02-2.53); DASH scores did not differ significantly. [11]"
          ],
          "bullets": [
            "Prioritize fixation when avoiding nonunion or malunion has high functional or occupational value and the fracture is completely displaced. [10][11]",
            "Favor nonoperative treatment when avoidance of operative complications is prioritized and displacement is not complete or the expected functional benefit is limited. [9][11]"
          ]
        }
      ],
      "table": {
        "caption": "Location- and displacement-based treatment framework. [6][7][9][10][11]",
        "columns": [
          "Fracture pattern",
          "Default direction",
          "Decision modifier"
        ],
        "rows": [
          [
            "Nondisplaced/minimally displaced lateral-third, extra-articular",
            "Nonoperative treatment. [6]",
            "Reassess if instability or displacement is present. [6]"
          ],
          [
            "Unstable or displaced lateral-third",
            "Consider operative fixation. [6][7]",
            "Segment stability, displacement, and age guide selection. [6]"
          ],
          [
            "Moderately displaced midshaft",
            "Nonoperative treatment can be satisfactory. [9]",
            "Discuss shortening, activity needs, and willingness to accept nonunion/malunion risk. [7][9]"
          ],
          [
            "Completely displaced midshaft in active adult",
            "Offer primary plate fixation. [10]",
            "Benefit: improved 1-year function and lower malunion/nonunion; tradeoff: more complications. [10][11]"
          ],
          [
            "Open fracture or neurovascular injury requiring repair",
            "Fixation indicated. [22]",
            "Requires urgent operative planning. [22]"
          ]
        ]
      }
    },
    {
      "id": "operative-options",
      "eyebrow": "Fixation",
      "heading": "Select fixation strategy after the decision to operate",
      "intro": "Plate fixation has the clearest direct comparison with nonoperative care for displaced midshaft fractures.",
      "paragraphs": [
        "For a completely displaced midshaft fracture selected for surgery, open reduction and plate fixation is supported by multicenter randomized evidence showing improved functional outcome and lower malunion and nonunion at 1 year versus sling treatment. [10] In the same evidence base, the observed union advantage should be discussed alongside the possibility of operative complications rather than presented as a complication-free alternative. [11]",
        "Intramedullary fixation is an alternative operative strategy for displaced midshaft fractures. A randomized-trial meta-analysis comparing plate fixation with intramedullary nail or Knowles pin fixation reported a statistically better DASH result with intramedullary fixation (mean difference 2.98, 95% CI 0.16-5.81), but heterogeneity was high (I² 89%). [13] Another report notes that studies have found no difference in functional outcomes or complications between plate and intramedullary fixation. [14]",
        "Avoid presenting one construct as universally superior. When an operative patient is considering plate versus intramedullary fixation, discuss the uncertainty in comparative functional estimates, the fracture pattern, and the surgeon's fixation plan. [13][14] External fixation has been evaluated in a small retrospective series, but plate fixation remains the operative method directly supported by the pivotal randomized comparison with sling management. [8][10]"
      ],
      "bullets": [
        "Plate fixation: direct randomized evidence versus sling in completely displaced midshaft fractures. [10]",
        "Intramedullary fixation: possible functional advantage in one meta-analysis, with high heterogeneity and conflicting comparative literature. [13][14]",
        "Do not extrapolate evidence for acute displaced midshaft fractures to minimally displaced or stable lateral-third fractures. [6][10]"
      ],
      "subsections": [],
      "table": {
        "caption": "Operative options for displaced midshaft clavicle fracture. [10][13][14]",
        "columns": [
          "Option",
          "Evidence-supported consideration",
          "Key limitation"
        ],
        "rows": [
          [
            "Open reduction and plate fixation",
            "Improves 1-year function and reduces malunion/nonunion versus sling in completely displaced midshaft fractures. [10]",
            "Operative treatment has a higher overall complication rate than nonsurgical care in RCT meta-analysis. [11]"
          ],
          [
            "Intramedullary nail or Knowles pin fixation",
            "Meta-analysis found a modestly better DASH result than plate fixation. [13]",
            "High heterogeneity limits certainty; other studies report no functional or complication difference. [13][14]"
          ],
          [
            "External fixation",
            "Small retrospective comparison reported favorable satisfaction and healing observations. [8]",
            "Evidence is limited relative to plate fixation versus sling randomized evidence. [8][10]"
          ]
        ]
      }
    },
    {
      "id": "follow-up-and-treatment-failure",
      "eyebrow": "Follow-up",
      "heading": "Monitor healing and identify nonunion or symptomatic malunion",
      "intro": "Follow-up should focus on union progression, persistent functional limitation, and complications of the selected treatment.",
      "paragraphs": [
        "For a nonoperatively treated displaced midshaft fracture, counsel that nonunion and malunion are the major adverse healing outcomes for which fixation offers relative risk reduction. [10][11] Persistent symptoms or functional deficit should prompt reassessment for symptomatic nonunion or malunion, because delayed reconstruction has been reported among patients whose initial nonoperative course resulted in malunion or nonunion. [22]",
        "After operative fixation, monitor for complications rather than assuming surgery eliminates risk. The RCT meta-analysis found more complications with ORPF than nonsurgical care, despite lower nonunion and malunion rates. [11] Functional exercise may begin early after operative management in reported practice, while heavy lifting or strenuous affected-limb activity was avoided for 3 months in one operative series. [15]",
        "If surgical treatment is deferred for an initially displaced fracture, document the patient's priorities: avoidance of surgery, tolerance of a higher healing-failure risk, cosmetic concerns, and activity requirements. Appearance dissatisfaction and shoulder contour defect were less frequent after ORPF in RCT meta-analysis, but no significant DASH difference was demonstrated in that synthesis. [11]"
      ],
      "bullets": [
        "Nonoperative displaced midshaft fracture: monitor for persistent pain, functional deficit, and healing failure that may indicate nonunion or symptomatic malunion. [10][11][22]",
        "Operative fracture: monitor for treatment complications as well as union; surgery reduces malunion/nonunion but does not reduce overall complications in the RCT meta-analysis. [11]",
        "After operative fixation, avoid heavy lifting or strenuous affected-limb activity for 3 months in the reported postoperative protocol. [15]"
      ],
      "subsections": [],
      "table": {
        "caption": "Outcome-focused follow-up priorities after treatment selection. [10][11][15][22]",
        "columns": [
          "Treatment course",
          "Outcome to assess",
          "Management implication"
        ],
        "rows": [
          [
            "Nonoperative displaced midshaft fracture",
            "Nonunion or malunion; reported nonunion can reach 15.1%. [8][10]",
            "Reassess persistent symptomatic cases for reconstructive fixation. [22]"
          ],
          [
            "Plate fixation",
            "Union, shoulder function, and operative complications. [10][11]",
            "Counsel that complication risk is higher than with nonsurgical care despite lower malunion/nonunion. [11]"
          ],
          [
            "Postoperative rehabilitation",
            "Tolerance of early functional exercise. [15]",
            "Avoid heavy lifting and strenuous use of the affected limb for 3 months in the reported protocol. [15]"
          ]
        ]
      }
    }
  ],
  "faq": [],
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  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
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      "snippet": "Schedule a CT scan or MRI to assess the extent of the fracture and plan the definitive management. 3. Consider admission for pain management, immobilization",
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      "snippet": "Title: Treatment of clavicle fractures: current concepts review - ScienceDirect\n# Review article Treatment of clavicle fractures: current concepts review. Current concepts of clavicle fracture management are discussed including surgical indications, techniques, and results. Because the majority of f",
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    {
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      "title": "Current concepts in clavicle fractures - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1877132719300806",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "# Upper limb trauma Current concepts in clavicle fractures. Clavicle fractures are common injuries which any orthopaedic surgeon encounters in the clinical practice. Clavicle fractures account for approximately 2–4% of all fractures, with an increase in incidence due to a higher involvement of popul",
      "score": 0.76847315
    },
    {
      "number": 8,
      "title": "Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0949265819301216",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures - ScienceDirect\n# Original Article Operative treatments compared with nonoperative treatment of displaced midshaft clavicular fractures. Few reports on external fixation to treat displaced mid",
      "score": 0.7092009
    },
    {
      "number": 9,
      "title": "Plate fixation of fresh displaced midshaft clavicle fractures - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0020138399001400",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "# Plate fixation of fresh displaced midshaft clavicle fractures. From 1992–1994, we operated on 251 fresh completely displaced mid-third clavicle fractures in adults; 232 were followed up. For completely displaced clavicle fractures in adults, plating is a reliable procedure. These data, however, ar",
      "score": 0.6729558
    },
    {
      "number": 10,
      "title": "Nonoperative Treatment Compared with Plate Fixation of... : JBJS",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jbjsjournal/fulltext/2007/01000/nonoperative_treatment_compared_with_plate.1.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Title: Nonoperative Treatment Compared with Plate Fixation of... : JBJS\nWe sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after plate fixation of displaced midshaft clavicular fractures. **Methods:** In a multicenter, prospective clinical",
      "score": 0.63397753
    },
    {
      "number": 11,
      "title": "Open reduction and plate fixation compared with... : Medicine",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/md-journal/fulltext/2019/05170/open_reduction_and_plate_fixation_compared_with.52.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Title: Open reduction and plate fixation compared with... : Medicine\nWe retrieved RCTs regarding open reduction and plate fixation (ORPF) and non-surgical method for the treatment of displaced midshaft clavicle fracture published before June 2018 from PubMed, EMBASE and Cochrane Library. The results",
      "score": 0.60750073
    },
    {
      "number": 12,
      "title": "Atypical Femur Fractures: Review of Epidemiology ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/edrv/article/40/2/333/5082430",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by DM Black · 2019 · Cited by 239 — The fracture is noncomminuted or minimally comminuted. Unilateral or bilateral prodromal symptoms such as dull or aching pain in the groin or thigh.",
      "score": 0.047837958
    },
    {
      "number": 13,
      "title": "Plate fixation versus intramedullary nail or Knowles pin... : Medicine",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/md-journal/fulltext/2020/09250/plate_fixation_versus_intramedullary_nail_or.32.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Plate fixation versus intramedullary nail or Knowles pin fixation for displaced midshaft clavicle fractures: A meta-analysis of randomized controlled trials. Plate fixation versus intramedullary nail or Knowles pin fixation for displaced midshaft clavicle fractures :a meta-analysis of randomized con",
      "score": 0.73778254
    },
    {
      "number": 14,
      "title": "Bilaterally Threaded, Minimal Invasive, Elastic Locking Intramedullary Nailing (ELIN) for the Treatment of Clavicle Fractures - Ullah - 2020 - Orthopaedic Surgery - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/os.12612",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "# Bilaterally Threaded, Minimal Invasive, Elastic Locking Intramedullary Nailing (ELIN) for the Treatment of Clavicle Fractures. To evaluate and present the effectiveness of this innovatively designed, elastic locking intramedullary nail (ELIN) in fixation of clavicle fractures. The only way to prev",
      "score": 0.69968605
    },
    {
      "number": 15,
      "title": "Comparison of the Effectiveness of Simple Plate Fixation and Plate Combined with Local Fixation of Broken Ends in the Treatment of Oblique Fracture of Midshaft Clavicle - Gao - 2022 - Orthopaedic Surgery - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/os.13310",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "We followed up patients with two different internal fixation methods for a long time, and conducted a follow-up study focusing on fracture healing, shoulder joint function score, and complications of the two groups of patients. We emphasized the following aspects: (i) the cost of internal fixation m",
      "score": 0.6991933
    },
    {
      "number": 16,
      "title": "Clavicle Fracture Research: Enough Already? - OrthoBuzz",
      "detail": "orthobuzz.jbjs.org",
      "url": "https://orthobuzz.jbjs.org/2019/04/03/clavicle-fracture-research-enough-already",
      "authors": "orthobuzz.jbjs.org",
      "host": "orthobuzz.jbjs.org",
      "snippet": "1.   \n2. McKee MD The Operative versus Non-operative Treatment of Common Upper Extremity Injuries: What Does Evidence Based Medicine Tell Us?  \nFractures of the Clavicle. OTA Annual Meeting Oct 12, 2013.  Accessed April 4, 2019  \n3. Robinson CM et al. Open Reduction and Plate Fixation Versus Nonoper",
      "score": 0.5246632
    },
    {
      "number": 17,
      "title": "Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis - Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK242544",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Cover of Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews\n\n## Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].\n\n# Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis\n\nReview ",
      "score": 0.4296453
    },
    {
      "number": 18,
      "title": "Intervenciones para el tratamiento de la fractura proximal ...",
      "detail": "www.cochranelibrary.com",
      "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000434.pub4/information/es",
      "authors": "www.cochranelibrary.com",
      "host": "www.cochranelibrary.com",
      "snippet": "... Primary Open Reduction Of Fracture And Internal Fixation With Plate · Bone Immobilization · Immobilization By Sling · Physical therapy exercises",
      "score": 0.3344378
    },
    {
      "number": 19,
      "title": "Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of medicine",
      "detail": "www.ccjm.org",
      "url": "https://www.ccjm.org/content/89/7/393",
      "authors": "www.ccjm.org",
      "host": "www.ccjm.org",
      "snippet": "### Healthcare costs\n\nThe management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost.20 A prompt, proactive respons",
      "score": 0.078367025
    },
    {
      "number": 20,
      "title": "JBJS Search",
      "detail": "www.jbjs.org",
      "url": "https://www.jbjs.org/sso.php?state=o%3Dlogout%26r%3Dhttps%253A%252F%252Fwww.jbjs.org%252Fsearch.php%253Fsortby%253Dauthors%2526sortorder%253Dasc%2526source%253Djbjs%252Bcase%252Best%252Breviews%252Bjopa%252Boa%2526type%253Dimagegroup%2526query%253Dshoulder%252B%2526elbow%253D%2526topic%253Dshoulder%252Band%252Belbow",
      "authors": "www.jbjs.org",
      "host": "www.jbjs.org",
      "snippet": "Displaced Midshaft Clavicle Fracture JBJS … radiograph of the right clavicle taken in the emergency department. Preoperative lateral radiographs showing the",
      "score": 0.36629558
    },
    {
      "number": 21,
      "title": "Best Read JBJS Reviews Articles in 2020",
      "detail": "sites.jbjs.org",
      "url": "http://sites.jbjs.org/Documents/JBJS_Reviews_Special_Edition_top_Ten_of_2020.pdf",
      "authors": "sites.jbjs.org",
      "host": "sites.jbjs.org",
      "snippet": "C o m p l i c a t i o n s a n d C o n t r o v e r s i e s i n t h e Ma n a g e m e n t o f 5 C o m m o n Pe d i a t r i c S p o r t s I n j u r i e s | DECEMBER 2020 · VOLUME 8, ISSUE 12 · e20.00013 3 For the remaining majority of ME fractures, management recommenda-tions are most consistently based",
      "score": 0.33711678
    },
    {
      "number": 22,
      "title": "PDF MID-SHAFT CLAVICLE FRACTURES; - applications.emro.who.int",
      "detail": "applications.emro.who.int",
      "url": "https://applications.emro.who.int/imemrf/Professional_Med_J_Q/Professional_Med_J_Q_2013_20_6_1006_1009.pdf",
      "authors": "applications.emro.who.int",
      "host": "applications.emro.who.int",
      "snippet": "The absolute indications for fixation of clavicle fracture fixation have been open fractures, polytrauma, associated neurovascular injury etc. Dr. Kashif Khurshid Qureshi, Dr. Zulfiqar Ahmed, Dr. Imran Asif Bajwa, Dr. Saeed Ahmed, Dr. Hassan Moin MID-SHAFT CLAVICLE FRACTURES; Surgical Management ORI",
      "score": 0.7348247
    },
    {
      "number": 23,
      "title": "نقش مداخلات جراحی برای درمان شکستگی‌های حاد یا ...",
      "detail": "www.cochranelibrary.com",
      "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007428.pub3/fa",
      "authors": "www.cochranelibrary.com",
      "host": "www.cochranelibrary.com",
      "snippet": "intramedullary fixation may give better results than plate fixation for acute clavicle fractures and non‐union.",
      "score": 0.6205532
    },
    {
      "number": 24,
      "title": "Intervenciones conservadoras para el tratamiento de la ...",
      "detail": "www.cochranelibrary.com",
      "url": "https://www.cochranelibrary.com/es/cdsr/doi/10.1002/14651858.CD007121.pub4/full/es",
      "authors": "www.cochranelibrary.com",
      "host": "www.cochranelibrary.com",
      "snippet": "Generally, conservative interventions to treat clavicle fractures can be grouped into arm‐supporting slings and bandages (simple sling, Velpeau bandage, or",
      "score": 0.45798564
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  ],
  "publishedAt": "2026-08-24T17:41:48.603048+00:00",
  "updatedAt": "2026-08-24T17:41:48.603048+00:00",
  "readingMinutes": 5,
  "slug": "clavicle-fracture"
}