Clavicle Fracture Fixation

The surgical treatment for a fractured clavicle is always tailored to the patient and the nature of the fracture.

The type and severity of the fracture must always be considered when considering its fixation. There are a number of different types of clavicle plate that can be used and one will be chosen specifically for your particular fracture. During your operation, the fracture is reduced and then fixed and held with a plate and screws so that the normal clavicle anatomy is restored as closely as possible. A sling is still used following the procedure but surgery can restore normal anatomy and therefore achieve an earlier return to function then if it were not fixed.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding
• Nerve injury; anterior chest numbness/plexus injury
• Shoulder stiffness
• Continued discomfort
• Mal-union
• Non-union

Before admission

• Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr Falworth who organised the investigations.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery.

In Hospital

• The surgical fixation of a clavicle usually undertaken as a single overnight stay or day case.
• A single incision measuring approximately 15cm is made over the length of the clavicle.
• The wound is repaired with dissolving buried sutures and Steri-strips
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your outpatient physiotherapy commences.

What to Expect

• Swelling; immediately after surgical procedure there can be quite a lot of swelling around the shoulder but this settles after approximately 24 hours. A Cryocuff or alternative cold therapy compress, can be helpful in minimising swelling and inflammation. The Cryocuff will usually be issued to you upon discharge
• Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
• Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.

Post-operative care

• A sling will be provided to help rest the shoulder. Unless otherwise informed this should be worn for six weeks to allow the soft tissue to heal and to also so protect the plate fixation. To prevent the development of undue shoulder stiffness, the belt that is attached to your sling should be removed 24 hours after your operation.
• The wound should be kept dry for 10 days.
• At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound. If not, please consult Mr Falworth or your GP for further advice.
• The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an out-patient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

Return to Functional activities