Challenge of the Week / Shoulder / 05.08.20

A 14-year-old male patient presents with right shoulder pain after being tackled at football practice. Images show a midshaft clavicle fracture with 1 cm of shortening and 80% displacement. The injury is closed and the patient has no change in his neurovascular examination. Which of the following would be definitive treatment for this patient’s injury?
  • Open reduction and internal fixation with an anteroinferior plate
  • Based on the patient’s age, examination, and degree of displacement, surgery is not indicated.

  • Open reduction and internal fixation with a superior nonlocking plate
  • Based on the patient’s age, examination, and degree of displacement, surgery is not indicated.

  • Nonoperative management with a sling or figure-of-eight harness
  • Nonoperative management is indicated based on the patient’s age, degree of displacement, and examination.

  • Open reduction and internal fixation with a superior locking plate
  • Based on the patient’s age, examination, and degree of displacement, surgery is not indicated.

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