CONSENSUS RECOMMENDATION A systematic literature review yielded no studies that met inclusion criteria for this clinical practice guideline. Outside the inclusion criteria, limited reliable evidence exists to guide surgeons on the optimal treatment of lateral clavicle fractures. Overall multiple surgical techniques have been described with newer techniques associated with improved outcomes and reduced re-operation. The work group is of the opinion that given the available evidence supporting modern techniques of fixation and the established high risks of non-union, surgical management may be appropriate in selected patients with displaced lateral clavicle fractures.
Benefits/Harms of Implementation
Surgical management of lateral clavicle fracture with coracoclavicular ligament injury may reduce the risk of non-union and improve patient outcomes. However, given the lack of supportive literature at the current time careful consideration must be made to avoid unnecessary operative interventions in this patient population.
Outcome Importance
Further understanding of the utility of surgical management of the displaced lateral clavicle fracture with Coracoclavicular ligament disruption may provide insight into the clinical effectiveness and cost effectiveness of the technique
Cost Effectiveness/Resource Utilization
No evidence related to cost or resource utilization is available on this topic. This would be an important area of further research to guide thoughtful health policy and treatment decisions.
Acceptability
Little change is required to implement this recommendation; thus, it is likely to be acceptable to most.
Feasibility
Implementation of this recommendation requires little additional surgical change however, public health resources and the associated cost of treatment may make this less feasible in some health care settings. Additionally, novel treatment techniques described to address this injury may require additional expertise or knowledge prior to implementation.
Future Research
Continued understanding of the impact of displacement, and the role of treatment on clinical outcomes is necessary.