Intraoperative Identification of Clavicle Fracture Patterns: Do Clavicles Fail in a Predictable Pattern?

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Biology

Background:

• Midshaft clavicle fractures are common injuries requiring operative management.
• Characterizing fracture patterns is crucial for surgical planning and achieving optimal reduction.

Purpose of the Study:

• To define the fracture and fragmentation patterns of displaced midshaft clavicle fractures undergoing operative repair.
• To correlate preoperative classifications with intraoperative findings.

Main Methods:

• Prospective observational study of 53 patients with midshaft clavicle fractures.
• Fractures classified using the Robinson classification.
• Intraoperative measurement of fragment length, location, and cortical read presence.

Main Results:

• 55% of fractures were classified as Robinson 2B2 preoperatively.
• Length-stable, anatomic reduction was achieved in 83% of cases.
• A cortical read was present in the posterior-superior aspect in 97.7% of reducible fractures.

Conclusions:

• Midshaft clavicle fractures exhibit predictable patterns, with butterfly fragments from compression and tension lines from posterior-superior forces.
• This predictable pattern aids in surgical planning for operative repair.