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. The fractures were plated with a Mizuho C-type plate or an AO/ASIF 3.5 mm reconstruction plate. Comminuted fragments were reduced and wired (133 cases). There were 150 men and 82 women; the median age was 37.3 years (range 18-79). The mean follow-up was 4.4 years (range 3.0-5.9). The mean time to radiographic union was 10 weeks. Seven patients (3%) developed nonunion. Healing with angulation occurred in 14 patients. Deep infection developed in one patient, and superficial infection in four cases; 21 patients reported soreness with changes in the weather and activity; 28 patients had residual skin numbness caudal to the incision. No patient had shoulder droop, and none had impairment of range of motion or shoulder strength. None developed new or late neurovascular impairment; 171 patients eventually had the hardware removed at an average 401 days post operatively. Overall, 94% were satisfied with the procedure. For completely displaced clavicle fractures in adults, plating is a reliable procedure.