Date: Sun, 26 Sep 1999 21:23:35 -0700

From: Robert Chandler

Subject: Clavicle shaft fractures

Has anyone had experience with either closed or open treatment of clavicular shaft fractures in throwing adults (pitchers, quarterbacks). I am trying to get some idea if there is a fact based rational for internal fixation or if high level recovery is possible without surgery.

Thanks, Bob Chandler

Reply at: Orthopaedic Trauma Association forum

Date: Mon, 27 Sep 1999 21:57:43 EDT

From: Tom DeCoster

There are many anecdotal cases of football quarterbacks returning to the NFL with nonoperative treatment of clavicle shaft fractures. I am certain that high level function is possible with nonoperative treatment of clavicle shaft fractures.

I am not aware of any series of high performance athletes, large or small, with clavicle shaft fractures in the literature nor any particular comparison of ability to return to high level function with operative or nonoperative treatment.


Date: Tue, 28 Sep 1999 18:50:07 +0200

From: Peter Schandelmaier

There was a Paper at The AAOS Meeting in 1998 about IM Pinning From Fort Bragg presenting excellent results with this kind of nail in these soldiers

Peter Schandelmaier

Date: Tue, 28 Sep 1999 23:46:01 EDT

From: Mark Weston

Dr. Carl Basamania (past Rockwood fellow) who now I believe is at Duke has studied functional outcomes of clavicles which have healed with deformity in soldiers. Demands on shoulder function in soldiers is high and outcomes from marked clavicular deformity often resulted in medical discharge from an inability to wear field equipment without pain as well as limitation in push up tolerance required for the standard army physical fitness test. Although I am not familiar with the exact details of his published results, these studies did lead him to recommend treatment of markedly displaced or shortened clavicular fractures with acute intramedullary fixation with Hagie pins for soldiers. He would be an excellent source of information on this issue.

Sincerely, Mark Weston MD, Spine Fellow, Orthopedics, Indianapolis

Date: Wed, 29 Sep 1999 12:00

From: Bill Burman

Some recent abstracts (since 1996) from NLM Grateful Med and the AAOS