1st order, depending on the exact form of the fracture.
- Osteosynthesis – joining the ends of the bones by inserting force carriers (plates or intramedullary stabilization) [see also under “Further notes”].
Osteosynthesis is indicated for the following conditions:
- Dislocation (displacement or twisting of bones or parts of bones in relation to each other) by more than one shaft width.
- Threatening spearing
- Vascular, nerve injury
- Fracture near the joint
- Luxation fracture
- Open fracture
- Refracture (repeated fracture) of the clavicle.
Other notes
- Young patients (> 18 years) with fracture in the middle third of the clavicle (70 to 80% of cases) treated surgically by open reduction with osteosynthesis by plates and screws returned to work sooner than the group treated conservatively with an arm sling (wear for 6 weeks, 3 of which were permanent).
- For clavicle shaft fractures of the middle third, an alternative therapeutic procedure to plate osteosynthesis for type A and B fractures is elastic stable intramedullary nailing (ESIN) with “titanium elastic nail” (TEN). Possible complications are: Pain over the medial end (in about 1 %, re-shortening was necessary). Telescoping could be observed in 5%, and lateral perforation (which did not occur intraoperatively) in 2%.
