For a non-displaced mid-clavicular fracture, which management approach is recommended initially?

For a non-displaced mid-clavicular fracture, which management approach is recommended initially?

• A. Sling for 2-6 weeks with passive range of motion as pain allows and physical therapy starting around 4 weeks.
• B. Rigid immobilization with a figure-of-eight bandage for 6-8 weeks.
• C. Immediate surgical fixation.
• D. Sling for 1 week with ROM delayed until after 8 weeks.

Answer: (A)

Nonoperative management with a simple sling is appropriate for a non-displaced mid-clavicle fracture because the bone heals well with conservative care, and the goal is to allow healing while preserving shoulder mobility. Immobilizing in a sling for a couple of weeks provides protection without the downsides of rigid immobilization, while allowing gentle movement as pain permits helps prevent stiffness. Starting passive range of motion as pain allows and initiating physical therapy around the fourth week supports gradual restoration of motion and strength without overloading the healing fracture. Surgery is not needed for nondisplaced fractures, since outcomes are good with nonoperative care; more rigid immobilization methods like a figure‑of‑eight bandage don’t improve results and can be uncomfortable. Delaying ROM for many weeks increases the risk of stiffness, so the approach of about 2–6 weeks in a sling with ROM started around week 4 strikes the right balance.

Nonoperative management with a simple sling is appropriate for a non-displaced mid-clavicle fracture because the bone heals well with conservative care, and the goal is to allow healing while preserving shoulder mobility. Immobilizing in a sling for a couple of weeks provides protection without the downsides of rigid immobilization, while allowing gentle movement as pain permits helps prevent stiffness. Starting passive range of motion as pain allows and initiating physical therapy around the fourth week supports gradual restoration of motion and strength without overloading the healing fracture. Surgery is not needed for nondisplaced fractures, since outcomes are good with nonoperative care; more rigid immobilization methods like a figure‑of‑eight bandage don’t improve results and can be uncomfortable. Delaying ROM for many weeks increases the risk of stiffness, so the approach of about 2–6 weeks in a sling with ROM started around week 4 strikes the right balance.