ABSTRACT
Fractures of the clavicle and proximal humerus usually heal readily with little more than symptomatic treatment. Failure to heal often reflects substantial malalignment, soft tissue interposition, high-energy fractures with greater soft tissue injury, or excessive early motion (1,2). Operations to gain healing must enhance both the biological and mechanical aspects of fracture healing (3-5). The biological aspects of healing are addressed by limiting devascularization of fracture fragments during exposure, by debriding interposed tissue, by stimulating bleeding, by debriding and drilling the sclerotic fracture surfaces, and by adding autogenous bone graft. The mechanical aspects are addressed by applying adequate plate and screws.
