Introduction
Surgery is recommended for:
- Displaced Fracture – significant fragment separation.
- Athletes.
- Those where the bump/shortening is a cosmetic concern.
The aim of surgery is to restore the normal anatomy of the clavicle and therefore the shoulder girdle and to prevent complication such as non-union or malunion (healing in wrong position).
This is performed with surgery known as Open Reduction Internal Fixation (ORIF) where the bone fragments are lined up and fixed with plate and screws to form a solid unit.
Procedure
The surgery is under general anaesthesia and can be performed as day only / one-night stay in hospital.
An approx. 4-8 cm incision is made over the clavicle. The fracture fragments are identified and brought back to normal position. It is held in that position with plate and screws.
An x-ray is taken during the operation to ensure the bones are back in normal position and that the plate and screws are placed correctly.
The skin is closed with dissolvable sutures and the arm is placed in a sling post operatively.
The plate can be taken out in the future if needed but is usually NOT necessary.
Recovery
- Day surgery / overnight stay procedure.
- Start gentle shoulder activities straight away (e.g.: dressing, eating, showering).
- Discard sling at 2 weeks.
- Drive at approximately 2 weeks.
- Overhead movement can start at approximately 2 weeks.
- Sports commence when fracture healed (approx. 6-12 weeks).
Results
Patient satisfaction in this surgery is 90-95%.
Majority of patients get their full movement and strength back between and return to sport 3-6 months post-surgery.
Risks and complications
These include:
- Numbness at scar site.
- Plate irritation.
- Non-union 1-3%.
- Infection 1-2%.
- Nerve Injury <1%.