During a previous post it was illustrated that non locking 3.5 reconstruction plates are sufficient for fixation of clavicle shaft fractures. However, distal clavicle fractures are challenging and they require multiple screws for the distal fragment. Re-enforcement of the fixation with suture that is wrapped around the coracoid as almost always necessary. These fractures are more challenging and require compliance with restrictions during the healing period to avoid biomechanical failure of the fixation.
The following case is a 30 year old M who presented to the office with a distal clavicle fracture after an altercation. Fixation was performed with a distal locking 3.5 plate and the reduction of the superior displacement of the clavicle was re-enforced with the use of #5 Fiberwire suture what was placed around the base of the coracoid. The pre-operative planning was essential for the use of a plate that allows placement of multiple distal locking screws.
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| 3D reconstruction and templating |
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| intraop images |
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| Immediate postop images |
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| 4 locking distal screws and suture fixation for the distal fragment |
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| Preoperatively (L side is the injured side) |
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| Postoperatively |
