“Limited Incision Plating of the Clavicle” – A new Surgical Technique David Duckworth and Nick Smith
Introduction: Methods of internal fixation of clavicle fractures include intramedullary devices and plate fixation. Intramedullary devices had the advantage of a smaller incision and therefore less paraesthesia distal to the scar. With more anatomical and less bulky plates we now have a surgical technique enabling one to fix clavicles through a similar size incision. This technique is both minimally invasive and without the complications of nailing and previous plates.
Methods: Over the last 6 months the authors has fixed 35 clavicle fractures in adolescents and females using an anatomical clavicle plate, through a small incision usually adopted for intramedullary devices. The technique involves an incision inferior to the clavicle and about half the size of the plate. As the plate is anatomical the clavicle can generally be reduced onto the plate and the skin elevated on either side of the plate. Follow up was made on all patients until union.
Results: All 35 patients went onto clinical and radiological union within 8 weeks. All scars were between 3.5 and 4.5cm. No significant paraesthesia was noticed. Full range of motion was achieved between 3 to 6 weeks. No plates have been removed due to irritation. Contact sports were allowed at between 6 to 8 weeks. No complications occurred.
Conclusion: That clavicle fractures can be stabilized through a limited incision technique due to new low profile anatomical plates. The incision is also made below the clavicle to decrease irritation under the skin. With this new technique range of motion and function is achieved quickly and reproducibly. This technique has also now been adopted for more complex clavicle fracture patterns.