AP chest radiograph demonstrating displaced midshaft

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AP chest radiograph demonstrating displaced
midshaft clavicle fracture with over 2cm of
shortening.
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Clinical picture demonstrating the prominence of
the clavicle and the clear displacement of the
fragments.
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The incision is made over what is projected to be
the inferior aspect of the clavicle once it is
reduced.
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The incision is brought directly down through
skin and platysma muscle to the periosteum.
Once the clavicle is identified, a subperiosteal
dissection is performed on the inferior edge of
the clavicle and circumferentially only at the
fracture site.
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The fracture reduction is demonstrated using a
clamp.
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When the inferior aspect of the bone is used for
the fixation, the plate does not need to be
contoured as much as when using the anterior
(superior) surface of the bone. This figure
demonstrates the clavicle reduction against a
reconstruction plate. A 3.5 DCP plate may also
be utilized.
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The plate is affixed to the distal fragment
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and the proximal fragment is then reduced and
fixed to the plate.
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The radiograph demonstrating the fixation using
an inferior position on the clavicle.
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Closure is performed as a full-thickness layer
over the plate. It is noted that the plate is
not prominent when placed inferiorly.
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Postoperative radiograph of the clavicle fixation.