A cost analysis of internal fixation versus nonoperative treatment in adult midshaft clavicle fractures using multiple randomized controlled trials.

Background: Displaced, midshaft clavicle fractures in adults have been traditionally treated nonoperatively based on older data reporting low rates of nonunion. With more recent studies now showing superior functional outcomes with operative treatment, a trend toward initial surgical intervention is being seen. The cost of healthcare is under constant scrutiny and it is important for physicians to understand costs associated with our chosen interventions. We have sought to add to the existing data available by creating a unique economic analysis of the cost of operative versus nonoperative treatment from the perspective of a single payer. We hypothesize that the cost of nonoperative treatment, including those who require delayed operative treatment, will be less than those receiving initial operative management.