Surgical treatment of unstable and displaced medial clavicle fractures with a contoured biplanar low profile angle stable implant.

OBJECTIVE

To achieve stable fixation to allow early mobilization by using a low profile contoured biplanar implant to avoid soft tissue problems and to minimize need for implant removal.

INDICATIONS: Unstable and displaced medial clavicle fractures in young patients with high functional demands.

CONTRAINDICATIONS: Open/contaminated fractures. Fractures in geriatric patients with low functional demands.

SURGICAL TECHNIQUE: Saber cut incision over the medial clavicle. Perpendicular incision to open the calvipectoral fascia. Fracture reduction and temporary retention. Contouring and attachment of the plate. Definitive plate fixation. Radiological documentation.

POSTOPERATIVE MANAGEMENT: Cryotherapy, anti-inflammatory medication on demand. Shoulder sling for comfort for 1-2 weeks. Physical therapy with active flexion and abduction limited to 90° for 6 weeks. Clinical and radiological follow up for 6-12 months.

RESULTS

In total, 5 patients were treated with the described technique. All patients were very satisfied with the result. The mean Constant-Murley score was 91 points and the mean Quick DASH (disabilities of shoulder and hand) was 3% after an average follow-up of 74 months. In none of the cases implant removal was necessary.