A 24-year-old man sustains a completely displaced midshaft clavicle fracture with 2 cm of shortening while playing football. He is right-hand dominant and works as a manual labourer. The most appropriate definitive management is:
- A Open reduction and internal fixation with an anterior-inferior plating ✓
- B Figure-of-eight bandage for 6 weeks
- C Intramedullary Kirschner wire fixation
- D Arm sling with early mobilisation as tolerated
Correct answer: A. Open reduction and internal fixation with an anterior-inferior plating
Explanation
Completely displaced midshaft clavicle fractures with more than 2 cm of shortening in young, active patients have higher rates of nonunion and symptomatic malunion with conservative care. Randomised evidence shows plate fixation improves union rates, shoulder strength and patient satisfaction in this subgroup. B simple sling is reasonable for undisplaced or minimally displaced fractures, and the figure-of-eight bandage offers no advantage over the sling and causes more discomfort.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.