Q: My son is a 16-year-old who was water-skiing last weekend and fell, fracturing his clavicle. At the emergency room, he was put in a sling and told to see an orthopedic surgeon. The orthopedic surgeon suggested surgery as the best chance of achieving normal function and strength in the shoulder. I went online and saw that most clavicle fractures will heal without surgery. What he should do?

A: Clavicle fractures, which usually occur in the middle third of the collarbone, have traditionally been treated with nonsurgical treatments such as a sling or a figure-of-eight clavicle strap. Some of these fractures are significantly displaced and in some cases can become a cosmetic deformity with a large bump, and occasionally may not heal at all.

Recent studies have suggested that surgery to fix a clavicle fracture and restore the normal anatomy is a better option, particularly for young, athletic individuals. The activity level of the patient, age, degree of displacement of the fracture and the number of pieces that the fracture is in -- these all are factors weighing in the decision to have surgery or pursue nonsurgical treatment. I recommend you get a second opinion, since you are uncertain about the best approach for your son.

The Jock Doc column runs every other week.

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