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Midshaft Clavicular Fractures: Open Reduction and Internal Fixation
Until recently, midshaft clavicular fractures were almost always managed nonsurgically. This treatment was largely the result of a presumed high rate of union based on early published studies; large cohort studies published in the 1960s demonstrated nonunion rates of less than 1% with nonsurgical management and 3% to 5% with surgical management. Nonunion is defined variably in the literature as a lack of radiographic healing at the fracture site 6 months or 1 year postoperatively. Literature published since the mid 1990s has indicated that few patients with fractures of the clavicular midshaft require surgical treatment.