Ban and Troelsen identified risk factors for nonunion of a fractured clavicle. The authors are from Copenhagen University Hospital Hvidovre in Denmark.

Patient selection: nonunion of a clavicle fracture


Nonunion defined as failure of the fractured bone to reunite by 24 weeks.


Overall nonunion rate: 7.5%


Risk factors for non-union:

(1) anatomic site (diaphysis)

(2) fracture complexity (displaced, isolated or comminuted segmental)

(3) female sex

(4) active smoking

(5) initial treatment nonoperative


Most fractures with nonunion were 2B2 by the Edinburg classification (complex midshaft fractures). In the implementation an extra point is given if the fracture is complex.


Most patients with nonunion improve after operative management but some patients may have persistent problems (complications 15%, lack of satisfaction 27%).

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