Biplanar Osteosynthesis for Severely Displaced Proximal-Third Clavicle Fracture

Abstract

Case: We present the case of a 41-year-old man with a displaced extra-articular proximal-third clavicle fracture managed with open reduction and double-plate internal fixation. Twelve months after the procedure, the patient had recovered full range of motion and returned to work. Conclusions: Proximal-third clavicle fractures are infrequent injuries and are usually treated conservatively. They are associated with thoracic injuries or high-energy dorsal or cervical spinal trauma. In the case of displaced fractures and small medial fragments, orthopaedic management may have unsatisfactory results, creating symptomatic nonunions and functional limitation, we propose a biplanar osteosynthesis, which could be an effective treatment.

Displaced medial clavicle fractures: a systematic review of outcomes after nonoperative and operative management

“…When the medial clavicle fragment is small or very comminuted and fixation is of concern, hook plates, 5 , 8 , 38 bridging plates to the sternum 12 , 26 , 39 and double-plating techniques 9 , 15 , 40 have been utilized to minimize the risk of fixation failure in multiple studies. However, despite high satisfaction and union rates, such fixation modalities typically require later removal.…”