Conservative Treatment Versus Operative Plate Fixation for Acute, Displaced Fractures of the Distal Clavicle

A Multicentre, Randomized Trial of Conservative Treatment Versus Operative Plate Fixation for Acute, Displaced Fractures of the Distal Clavicle

This is a multicentre randomized clinical trial prospectively comparing operative treatment versus conservative (nonoperative) care in the management of displaced distal (Type II) clavicle fractures.

Inclusion Criteria:

• Men or women aged 16 to 60 years of age
• Completely displaced (no cortical contact), closed fracture of the distal 3rd of the clavicle (Type II) confirmed by radiograph
• Fractures within 28 days post injury
• Provision of informed consent

Exclusion Criteria:

• Pathological fractures
• Non-displaced (cortical contact) distal clavicle fractures
• Open clavicle fractures
• Presence of vascular injury
• Fractures more than 28 days post-injury
• Limited life expectancy due to significant medical co-morbidity
• Medical contraindication to surgery
• Inability to comply with rehabilitation or form completion
• Likely problems, in the judgement of the investigators, with maintaining follow-up (i.e. patients with no fixed address, patients not mentally competent to give consent, etc.)