In the orthopaedic literature related to adults, newer reports demonstrating poor results of nonoperative management have emerged. In 2007, the Canadian Orthopaedic Trauma Society reported a multicenter, randomized trial comparing plate fixation with nonoperative treatment for displaced midshaft clavicle fractures in patients between six teen and sixty years of age (mean age, 33.5 years) In that study, the operative group had significantly fewer nonunions and symptomatic malunions as well as higher DASH and Constant scores. A recent metaanalysis confirmed these findings but also called into question the long-term gains of operative fixation in adults