**7. Treatment of delayed, mal-unions and non-unions**

Treatment of midshaft clavicular fractures is easier if performed within 28 days of the fracture as much of the dissection of the fracture ends has been done by the trauma. Union rates are higher in the acute group, while complications are lower, implying that the decision to operate should ideally be made in the first month [34]. When treating a mal- or non-united mid shaft clavicular fracture, caution is required because the anatomy is likely to be distorted and adhesions may increase the risk of damage to neuro-vascular structures when osteotomizing a mal union or mobilising and debriding a non-union. Our technique of using intramedullary reamings aids the healing of these cases. A small curette is an excellent tool to locate and develop the medullary canal safely for implant insertion.
