Broken Collar Bone (Clavicle Fracture) Repair Overview
Surgical fixation of the clavicle is being recommended more frequently in order to promote healing. Recent studies indicate long-term shoulder weakness and mal-union from fractures with an overlap or a distraction of more than 1 centimeter when left untreated. A new intramedullary fixation technique has permitted normal alignment and restoration of length of the clavicle with an early return to work and sports. The risks of surgery, including non-union and infection, are still present; however, for athletes who want to return to full sports as early as possible, and for people who are concerned about optimal anatomic alignment and healing, this technique has served these patients well.

Broken Collar Bone (Clavicle Fracture) Slideshow
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Surgical treatment - Indications
- Mid-shaft clavicle fractures with overlap or displacement greater than 1 centimeter
- Tenting of skin by fracture fragments
- Active patient with desire for early return-to-work and healing with no loss of length or
     strength

Surgical intervention can allow the patient to
- regain length
- regain stability
- return to work

Furthermore, surgical fixation will promote proper healing by preventing
- overlap between the fractured bone
- development of a fibrous non-union

Surgical Technique
The patient is seated in the beach-chair position after an interscalene local anesthetic block is placed. The fracture ends are opened with a scalpel and cleaned. A guide pin is passed into the medial portion of the clavicle under fluoroscopic x-ray control and over-drilled to fit a 6.5 mm or 4.5 mm screw. The guide pin is then removed and passed into the lateral clavicle fragment and similarly over-drilled. The pin is directed out the back of the clavicle. The drill is attached to the exiting end and redirected to pin the full length of the clavicle under x-ray control. Finally, a cannulated screw and washer is passed from the back down the bore of the clavicle to repair the fracture. Care is taken to engage, but to not penetrate, the medial end of the cortex of the bone. The incision is then closed.


Broken Collar Bone Rehabilitation