Nonunion of the Clavicle

The clavicle is the bone in the body most frequently fractured, accounting for 5% to 10% of all fractures.¹ Because of the difficulty of completely immobilizing fractures in this region, more than 200 different methods of treatment have been suggested. However, despite the apparent dissatisfaction with methods of fixation, nonunion is rare. Annersten in 1948² reviewed 350 cases and found the incidence of pseudarthrosis to be 1.3%. A review of the English-language literature reveals only three studies of 18 or 20 cases each and one of nine cases.^3-6 It has been stated that nonunion is becoming more frequent,⁷ but it is not certain whether this is due to an increased severity of injuries (secondary to the increased trauma in accidents associated with higher speeds of vehicles), a complacent attitude about the initial treatment, or more frequent open reduction of fractures.

Of the reports mentioned, one, by