Clavicle Fracture Fixation: Restoring Function and Strength

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A clavicle fracture, or broken collarbone, is a common injury, particularly in sports and trauma cases. The clavicle connects the sternum to the shoulder and plays a vital role in shoulder movement and stability. When a clavicle fracture is significantly displaced or comminuted (broken into several pieces), surgical fixation may be necessary.

What is Clavicle Fracture Fixation?

Clavicle fracture fixation involves surgically aligning the broken bone fragments and securing them with hardware. The main techniques include:

  1. Plate and Screw Fixation: The most common method, where a plate is attached to the clavicle with screws to hold the fragments in place.
  2. Intramedullary Fixation: This involves inserting a rod or pin through the bone marrow cavity of the clavicle to stabilize the fracture.

Important Anatomic Structures

  • Clavicle: Also known as the collarbone, it is a long, slender bone that connects the sternum to the shoulder.
  • Sternoclavicular Joint: The joint where the clavicle meets the sternum.
  • Acromioclavicular (AC) Joint: The joint where the clavicle meets the acromion of the shoulder blade.
  • Subclavian Vessels and Brachial Plexus: Important blood vessels and nerves that run under the clavicle, which need to be protected during surgery.
  • Deltoid and Trapezius Muscles: Muscles attached to the clavicle that are important for shoulder movement and stability.

Steps in Performing Clavicle Fracture Fixation

  1. Preoperative Preparation: The patient is positioned supine or in a beach-chair position, and the affected area is sterilized. A tourniquet may be applied to control bleeding.
  2. Incision: A skin incision is made over the clavicle to expose the fracture site.
  3. Exposure and Reduction: The fracture fragments are carefully exposed, and the bone is realigned to its normal anatomical position.
  4. Fixation: In plate and screw fixation, a plate is contoured to fit the clavicle and secured with screws. In intramedullary fixation, a rod or pin is inserted through the bone marrow cavity.
  5. Closure: The incision is closed with sutures, and a sterile dressing is applied.
  6. Postoperative Care: The patient is monitored in recovery, and instructions are provided for sling use and physical therapy.

Benefits of Surgical Fixation

  • Optimal Alignment: Surgery ensures proper alignment, which is crucial for shoulder function and aesthetics.
  • Early Mobilization: Patients can begin gentle shoulder movements sooner, reducing stiffness and promoting faster recovery.
  • Reduced Risk of Nonunion: Proper fixation lowers the risk of the bone not healing correctly or at all.

Recovery and Results

After surgery, patients typically wear a sling for a few weeks. Physical therapy is essential to restore shoulder strength and range of motion. Most patients achieve full recovery within a few months, with excellent functional outcomes.

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