This narrative review examines the management of distal clavicle fractures, focusing on the controversy between surgical and nonsurgical treatment — particularly whether the well-documented radiographic nonunion rate in Type II fractures actually translates to worse clinical outcomes.
When you see a displaced Type II distal clavicle fracture, counsel the patient that radiographic nonunion is common (up to 44%) but clinical outcomes are equivalent with or without surgery — operate for open fractures, vascular injury, skin compromise, or high-demand patients who prefer surgical stabilization, and favor locking plate with supplementary CC fixation over transacromial K-wires given the wire migration risk.
This narrative review examines the management of distal clavicle fractures, focusing on the controversy between surgical and nonsurgical treatment — particularly whether the well-documented radiographic nonunion rate in Type II fractures actually translates to worse clinical outcomes.
When you see a displaced Type II distal clavicle fracture, counsel the patient that radiographic nonunion is common (up to 44%) but clinical outcomes are equivalent with or without surgery — operate for open fractures, vascular injury, skin compromise, or high-demand patients who prefer surgical stabilization, and favor locking plate with supplementary CC fixation over transacromial K-wires given the wire migration risk.