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)