Biologic Fixation through Bridge Plating for Comminuted Shaft Fracture of the Clavicle: Technical Aspects and Prospective Clinical Experience with a Minimum of 12-Month Follow-up

Traditionally, midshaft clavicle fractures have been con-sidered to be injuries that rarely require open reduction. The reported nonunion rates following surgical fixation of midshaft clavicle fracture were higher than those re-ported following nonoperative treatment.1,2) Rowe has also reported nonunion in 0.8 % of fractures treated by closed methods and in 3.7 % treated by open reduction.3) Re-cently, in a prospective, long-term follow-up study, Nowak et al.4) found that as many as 46 % of the patients did not consider themselves fully recovered (sequelae) after 9 to 10 years, while the nonunion rate 6 months after injury was 7%. More recent studies2) have suggested the higher complication and nonunion rates of up to 15 % following nonoperative treatment, in particular for patients with displaced midshaft clavicle fractures. Due to the increas