Are standard antero-posterior and 20° caudal radiographs a true assessment of mid-shaft clavicular fracture displacement?

Aims: Decision-making in management of clavicle fractures is often based on the degree of displacement and shortening present on plain radiographs. We aimed to evaluate whether plain radiographs provide an accurate representation of the true displacement present, which can be difficult to image in orthogonal planes.

Methods: Consecutive high-energy trauma patients with midshaft clavicular fractures requiring further CT imaging of the thorax/abdomen for other associated injuries between 2009 and 2012 were evaluated.