Plating of a periarticular medial clavicle fracture

This article describes a case of a 23-year-old man who sustained a far medial fracture dislocation of the medial clavicle. We performed an open reduction and internal fixation of the fragment back to the remaining medial fragment using a small locking plate. This fracture can be problematic and usually requires reduction due to the potential vascular or airway compromise. Because the fracture often occurs at the medial physis, it is difficult to secure in place to prevent displacement. Historically, fixation of this fracture has been problematic with sutures and K-wires. Failure of fixation and migration of K-wires have been reported. In the past, plates have been inadequate or too large for this area to provide fixation. With the development of locking plates, a fixed-angle construct can be created to secure a small periarticular portion of bone as in the distal radius. In our case, the small distal radius locking plate was able to secure the lateral shaft to the medial piece with good stability in the medial clavicle. We were able to get multiple screws in the medial fragment in a low-profile plate. Postoperatively, the patient was permitted to use his arm for most activities but was restricted from pushing, pulling, or lifting heavy objects for 4 weeks. He recovered well and returned to normal activities of daily living with no restriction. Therefore, these plates may have a role in fixation of periarticular fractures.