Definitive Management of Open Clavicle Fracture with Locking Compression Plate as External Fixator

Open clavicle fracture is an uncommon injury caused by severe direct trauma. In situations of bony exposure, significant contamination, and severe soft-tissue damage, external fixation is the treatment of choice as it provides stable fixation with minimal local tissue damage resulting in excellent union rates and better soft-tissue outcome. Disadvantages of traditional external fixation are bulkiness and sharp edges causing discomfort to the patient.

We present an interesting case of a 25-year-old male who presented to our trauma care center with a history of fall from two wheeler, sustaining injury to his left shoulder. On examination, a Type IIIB open clavicle fracture was noted. He was treated with debridement and external fixation with a locking compression plate (LCP). Vacuum-assisted closure and culture sensitive intravenous antibiotics were administered for 5 days. Post-operative follow-up was satisfactory with no signs of infection and radiological evidence of fracture healing by 3 months.

External fixation with LCP for clavicle fracture is a simple procedure and can be used as a definitive treatment for Type III B open clavicle fracture. Advantages include anatomical reduction, less bulk, and stable fixation. It causes less skin irritation and is comfortable to the patient ensuring good patient compliance until removal. However, the pre-operative planning and surgical technique, such as plate length, the number of locking screws, screw positioning, and locking technique, should aim to create stable fixation and avoid excessive screw penetration.