Intramedullary Clavicle Fixation Through a Posterolateral Portal: Description of a Novel Minimally Invasive Technique

Over the last two decades, operative management of clavicle fractures has become more commonplace. Although traditionally treated with plating techniques, clavicle fractures have also been treated with intramedullary fixation (IMF). While IMF is less invasive, it is not without complications, including hardware migration, and related symptoms. This study presents a novel method of clavicle IMF using titanium elastic nails inserted through the posterolateral clavicle. The principal investigator's experience with the novel technique at a singular institution was reviewed to develop a comprehensive guide. A singular surgeon has used a novel posterolateral IMF technique for clavicle fractures over 15+ years at a level 1 trauma and tertiary care system, reporting a high union rate with minimal complications. This technique is technically easy, decreases risk of implant prominence or hardware failure requiring removal, does not result in central hardware migration or cause considerable supraclavicular nerve numbness, and produces a cosmetically pleasing result. (Journal of Surgical Orthopaedic Advances 35(2):107-110, 2026).