Operative Fixation of a Displaced Midshaft Clavicle Fracture

Midshaft clavicle fractures are frequently encountered orthopaedic injuries. Significant displacement portends a higher likelihood of nonunion and symptomatic malunion after nonoperative treatment. Surgical fixation has been shown to reduce the rate of these adverse outcomes. However, the benefit of surgery is narrowly defined and the decision to offer operative treatment involves a careful analysis of patient clinical factors, expectations, and concomitant injuries. In North America, fixation is most commonly performed with a precontoured plate and screw construct. Frequently, fracture patterns are amenable to direct reduction and primary bone healing, but the plate may also be used as a bridging construct for comminuted fractures. This video demonstrates the superior approach to clavicular plating. We detail the exposure, reduction, and fixation using lag screws and stabilization with a plate and screw construct.