Clavicle fixation improves fracture union but offers limited functional advantage .

Does surgical fixation of displaced midshaft clavicle fractures translate into better shoulder function? A meta-analysis of 15 randomized controlled trials involving 1713 patients found that surgery improved fracture union and reduced malunion compared with nonoperative management. However, these structural advantages did not produce clinically meaningful improvements in shoulder function, while surgery introduced implant-related complications and potential reoperations. The findings reinforce the importance of shared decision-making, particularly when patients prioritize avoiding surgery over radiographic union.