The bony anatomy of clavicular malunions☆

The majority of clavicle fractures heal with some degree of malunion. There has been an increased appreciation that malunion with significant shortening may lead to clinical symptoms. In a review of a large number of clavicle specimens, 73 fractures with 54 malunions were found. Distinctive patterns of malunion were identified. Shortening usually comprised a combination of overlapping and angulation of fracture fragments in a predictable fashion. An appreciation of these fracture patterns will be of interest to surgeons attempting to minimize or correct complications from such injuries. (J Shoulder Elbow Surg 2003;12:173-8)