A 26-year-old man falls off his bicycle onto his shoulder. X-ray shows a completely displaced fracture of the middle third of the clavicle with 2.5 cm of shortening and tenting of the overlying skin. The most appropriate management is:
- A Open reduction and internal fixation with a plate ✓
- B Figure-of-eight bandage for six weeks
- C Arm sling with weekly radiographs
- D Closed reduction and percutaneous pinning
Correct answer: A. Open reduction and internal fixation with a plate
Explanation
Absolute indications for primary fixation of a midshaft clavicle fracture include skin tenting or threatened perforation, and relative indications include shortening greater than 2 cm and complete displacement in a young active adult. Skin tenting risks progression to an open fracture and demands operative stabilisation, usually plating. B sling or figure-of-eight bandage is reserved for undisplaced or minimally displaced fractures without soft tissue compromise.
Reference: Apley and Solomon's System of Orthopaedics and Trauma, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.