What is the treatment for a 1.6cm displaced clavicle fracture in an adult or adolescent with no significant pre-existing medical conditions?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: January 12, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Treatment of 1.6cm Displaced Clavicle Fracture

A 1.6cm displaced clavicle fracture meets the surgical threshold and should be treated with operative fixation to reduce the risk of nonunion, symptomatic malunion, and to optimize functional outcomes. 1

What the Displacement Means

A 1.6cm displacement indicates significant fracture separation that exceeds the critical threshold for surgical intervention:

  • The American Academy of Orthopaedic Surgeons defines shortening exceeding 1.5cm as an indication for surgical treatment in displaced midshaft clavicle fractures 1
  • Displacement of this magnitude is associated with up to 15% nonunion rates when managed conservatively 2
  • Widely displaced fractures frequently result in symptomatic malunions that adversely affect shoulder strength and function, in addition to cosmetic concerns 2
  • The fracture fragments typically form a "Z" deformity due to the pull of the pectoralis major and the weight of the arm 2

Recommended Treatment Approach

Initial Assessment

  • Obtain upright radiographs rather than supine films, as they better demonstrate the true degree of displacement 1
  • Assess for neurovascular compromise or skin tenting that would require urgent intervention 1
  • Evaluate for complete displacement (>100% with no cortical contact between fragments), which requires urgent orthopedic follow-up 1

Surgical Management (Recommended for Your Case)

Surgical fixation is the preferred treatment for your 1.6cm displaced fracture based on the following evidence:

  • Surgical treatment provides higher union rates and better early patient-reported outcomes compared to conservative management 1
  • Surgery results in faster functional and radiographic recovery, allowing earlier return to work 2
  • Multiple randomized controlled trials demonstrate equivalent or improved short-term patient-reported outcomes with reduced rates of nonunion or symptomatic malunion compared to nonsurgical treatment 2

Surgical Options

Plate fixation:

  • Manufacturer-contoured anatomic clavicle plates are preferred due to lower rates of implant removal or deformation 1
  • Anterior inferior plating may lead to lower implant removal rates compared with superior plating 1

Intramedullary nailing:

  • Provides equivalent long-term clinical outcomes to plate fixation with similar complication rates 1

Post-Operative Rehabilitation

  • Use a sling for immobilization (preferred over figure-of-eight brace) 1
  • By 4 weeks: discontinue sling for routine activities but avoid lifting, pushing, or pulling 1
  • 8-12 weeks: full weight-bearing activities allowed based on radiographic evidence of healing 1
  • Include muscle strengthening exercises with long-term continuation 1

Important Caveats

Smoking Status

  • If you smoke, this significantly increases nonunion rates and leads to inferior clinical outcomes 1
  • Smoking cessation should be strongly encouraged before and after treatment

Long-Term Outcomes

  • While surgical treatment provides better early outcomes and faster recovery, long-term patient-reported outcomes and satisfaction are similar between surgical and nonsurgical approaches 1
  • This means the primary benefit of surgery is avoiding nonunion/malunion complications and achieving faster return to function

Conservative Management (Not Recommended for Your Case)

Conservative treatment would only be appropriate for non-displaced or minimally displaced fractures (well below your 1.6cm displacement) 1. With your degree of displacement, nonsurgical management carries unacceptable risks of:

  • Nonunion rates up to 15% 2
  • Symptomatic malunion affecting shoulder strength and function 2
  • Cosmetic concerns 2
  • Longer time to return to work 1

References

1
Guideline

Clavicle Fracture Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Related Questions

What are the symptoms and treatment of a clavicle fracture?
What is the definition of a clavicle fracture?
What is the appropriate management for a 40-year-old male patient with a nonunion of a displaced mid-left clavicle fracture, presenting with pain and visible deformation?
What could be causing my clavicle to protrude and what treatment options are available?
How to approach a 24-year-old male patient with a fracture of the clavicle (collarbone) who develops yellowish discoloration of the sclera and elevated direct bilirubin levels with slightly raised Serum Glutamic-Oxaloacetic Transaminase (SGOT) levels on post-operative day 4?
Can congenital nasolacrimal duct blockage be unilateral in a 2-month-old patient?
How long after dialysis can a patient with pleural effusion and a history of kidney disease, possibly complicated by hypertension, diabetes, or cardiovascular disease, expect to feel relief?
What are the necessary accommodations and precautions for a 61-year-old female patient with bilateral cochlear implants to ensure effective communication and safety in her daily environment?
What characteristics should I look for to suspect contamination in blood culture isolates and what is the typical time to positivity to consider an organism as a true pathogen?
What is the recommended initial dosage of levothyroxine (thyroxine (T4)) for a patient with overt hypothyroidism, considering their age and weight?
What is the best treatment approach for a female patient with menorrhagia (excessive menstrual bleeding) and a regular menstrual cycle?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question