Matt is a 26 year-old male who achieved improvement of his symptoms after surgery for a malunited clavicle fracture.

Matt fractured his clavicle in 2019, breaking the bone into 4 separate pieces. He was initially treated without surgery, causing the bone to heal in a displaced and abnormal position as seen on the X-ray image above. Healing in this way is described as malunion.

Matt came to see me after experiencing over a year of pain, clicking at the joint and an unpleasant awareness that the shoulder was shortened and out of position. During my examination it was clear that the abnormal position and shape of the clavicle was causing instability and partial dislocation at the joint between the clavicle and the sternum (breastbone). The asymmetry can be seen in the images below.

We arranged a 3D CT scan and 3D model of the bone, which allow a better understanding of the geometry and anatomy of the fracture. Matt and I discussed the options for treating this difficult case, and Matt decided to undergo surgery to correct the deformity.

During the surgery I made two separate cuts in the bone, allowing it to be repositioned and brought out to its correct length. The position of the cuts (or Osteotomy sites) were determined from his original fracture and from the 3D model. The newly aligned clavicle was held in place with a plate and screws, and excess bone was used as graft to stabilise the position and encourage healing of the bone. X-rays taken during and after the operation showed that the clavicle was back in its anatomical position.

Matt recovered from surgery well, and after resting his shoulder in a sling for several weeks was able to gradually return to full movement over a 6 week period. When he woke up from the surgery he already felt that his shoulder was more comfortable and sitting in its normal position. The clicking and popping sensation of the shoulder disappeared, and the joint between the clavicle and sternum is well aligned and stable. Matt is very happy with the outcome of his procedure.