Step-Cut Clavicle Osteotomy and T-Shaped Iliac Crest Graft for Clavicle Nonunion Using 3-Dimensionally Planned Custom-Made Surgical Guides and Plate Fixation.

Clavicle fractures are common, with nonunion rates reaching up to 31% without surgery. Surgical treatment with plate fixation and iliac crest autograft enhances healing, yet accurate reconstruction remains challenging owing to clavicular morphology. This study presents a surgical technique using virtual surgical planning to create 3-dimensionally printed patient-specific surgical guides and a custom-made clavicle plate. This approach enables precise osteotomies, optimal graft shaping, and accurate anatomic reconstruction. The T-shaped autograft provides enhanced stability and increased bone contact, while the custom plate facilitates compression and interfragmentary fixation.